Inspection on 26/05/06 for Ridgeway Care Home

This inspection was carried out on 26th May 2006.

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.

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

CARE HOME ADULTS 18-65 Ridgeway Care Home 11 Park Avenue Gillingham Kent ME7 4AS Lead Inspector Andrea Leverett Unannounced Inspection 26th May 2006 09:30 Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 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 Ridgeway Care Home DS0000066240.V297569.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 Adults 18-65. 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. Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ridgeway Care Home Address 11 Park Avenue Gillingham Kent ME7 4AS 01634 851443 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) Evesleigh (Kent) Limited Linda Jean Wilson Simmons Care Home 8 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (2) of places Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 6 People with Learning Disabilites 2 Older People with Learning Disabilities Date of last inspection 27/01/06 Brief Description of the Service: Ridgeway Care is a large semi-detached property, providing accommodation on three floors. It is located in a residential area, opposite a large park and within walking distance of shops. Public transport is easily accessible. The home provides care and support to adults with learning disabilities and challenging behaviour. They are currently registered for 8 service users, but at present there are only four living in the home. The two largest bedrooms, which are currently empty, were formally shared rooms - and are awaiting refurbishment. Since the last inspection the Home has changed hands and is now managed by Evesleigh Kent) Limited. The registered manager manages the home on a daily basis, and eight members of staff who promote and maintain service users choices and independence support her. The charges for services currently range from £300.00 to a £1,000 a week depending on needs. Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced key inspection of this service with its new service providers. The registered manager was present throughout the inspection and supported the process positively.Three staff were on duty in addition to the manager at the time of the inspection. There were some requirements and recommendations made at the previous inspection, which took place in January 2006, and all of these have been actioned. There were four service users present in the home at the time of the inspection and the inspector was able to spend time talking to them. In addition the inspector spoke with 2 staff and the manager. Activities were being undertaken at the time of the inspection and the atmosphere and interaction between staff and service users was observed to be relaxed and friendly. A tour of the premises was undertaken and it was noted that considerable environmental improvements have been made since the last inspection. In addition the service user and staff records and the homes pre inspection questionnaire were used to evidence judgements. Overall this was a very positive inspection, and the manager and staff evidenced throughout that they are committed to the best interests of the service users within the home. What the service does well: Service Users’ needs are fully assessed prior to moving into the home and the manager and staff have a good understanding of individual needs. The overall quality of care and support is very good, and staff demonstrated positive relationships with the service users. The daily routines of the home are focussed on the service users and supporting them in their daily living choices. Improvements to the service users’ environment continue to be made and overall the quality of the decoration and furnishings is good. The Home has a modern coordinated feel and was clean and well cared for by staff. Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The current service providers have only recently taken over and consequently the inspector was pleased to see comprehensive policies and procedures already in place. However it is acknowledged by the manager that in the best interest of service users these generic policies need to be reviewed in order to ensure that they meet the needs of service users in this Home. Ridgeway Care Home DS0000066240.V297569.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. Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The quality of service in this outcome group was judged to be excellent. Prospective service users can be confident that their individual aspirations and needs will be assessed. EVIDENCE: The inspector viewed assessments and care plans of the service user recently admitted to the Home. The inspector was impressed with the range of good quality information that was obtained before a decision to offer a service was made. The assessments including health assessments were detailed and comprehensive. Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 The quality of service in this outcome group was judged to be good. Service users benefit from detailed and clear care planning processes, which are followed by staff in order to meet their needs. Service users benefit from a care planning system and staff team that respects their right to make decisions and act upon the choices that are made. Comprehensive risk assessments support and promote the rights of service users so they are able to make informed decisions with regards to their daily living. EVIDENCE: Two care plans were viewed including that of the most recently admitted service user. Again the inspector was impressed with the range and detail of the care/person centred plans, which had clearly been drawn up with the involvement of the service users. They included detailed life and leisure plans, risk assessments and ABC charts and are now being reviewed monthly as recommended at the last inspection. Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 11 Risk assessments are in place and these are reviewed on a regular basis – they are aimed at supporting service users to maintain an independent lifestyle as possible and support service users in accessing daily living activities both in the home and out in the community. It was evidenced from records, daily notes and discussions with service users and staff that service users are supported to make decisions about their daily living and those choices are respected. Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 The quality of service in this outcome group was judged to be excellent. Service users benefit from living in a Home that respects their right to choose and take part in a range of age and culturally appropriate activities, both at Home and in the community. Service users benefit from a staff team that work hard to support them to promote and maintain family contacts in line with their wishes and best interests. Service uses choose and enjoy eating a varied and healthy diet. EVIDENCE: Care plans, daily records and discussions with service users and staff evidenced that service users undertook a range of activities both in the Home and in the community. Appropriate levels of resources are made available for service users to enjoy a healthy varied life style both at Home and in the community and the Home also has its own transport for the benefit of service Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 13 users. Service users undertake holidays, which they have helped plan and choose and educational, therapeutic and social activities are undertaken daily. Records, daily notes and discussions with service users confirmed that they were able to maintain relations with family and friends as appropriate. The inspector was impressed with the sensitive and respectful approach that the Home had taken on behalf of a service user in order to re establish family contact. It was clear that food was given a high priority within the Home and service users confirmed that they enjoyed their meals and meal times. An inspection of the home’s kitchen and menu’s confirmed that a range of fresh healthy food was made available. Service users and records seen confirmed that alternatives were offered at meal times in keeping with service users preferences and dietary needs. Food was stored appropriately and records showed that staff involved in food preparation had undertaken Food Hygiene training. Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 The quality of service in this outcome group was judged to be excellent. The Home ensures that service users benefit from having their physical and emotional health needs met and that they are given personal supported in a way that they prefer and require. Service users are protected by the home’s medication policies and procedures for dealing with medicines. EVIDENCE: Service user assessments and care plans and discussion and observation of service users evidenced that they had good access to routine and specialist health care. The manager and staff worked proactively with health professionals in the best interests of service users. Observation on the day and discussion with service users and staff indicated that support with personal care was offered appropriately and sensitively. Time and effort were taken to establish level of appropriate support needed and work was undertaken to promote service users independence and improve their personal care skills. Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 15 The inspector tracked the Medication for one service user and medication storage and a sample of Medication Administration Record sheets were looked at. Storage and recording of medication was good and information was available regarding side effects and circumstances for taking PRN medication. There was also an example of the Home working in partnership with the GP to reduce medication in the best interest of service users. Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The quality of service in this outcome group was judged to be good. Systems are in place in ensure that service users views are sort listened to and acted upon. Service users are protected from abuse, neglect and self-harm. EVIDENCE: Service users views are sort on a regular basis both in meetings and on a 1:1 basis. Views are recorded and acted upon both as part of the person centred planning process and the homes rigorous quality review system. A complaints procedure is in place, which includes al the information required by this standard. The Home has comprehensive adult protection policies and procedures and staff training records showed that Adult protection training had been undertaken. The inspector was impressed to see that this training was also extended to service users who wished to take part. Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 The quality of service in this outcome group was judged to be good. Service users benefit from a living in a Home that is homely, comfortable, clean and safe. EVIDENCE: A tour of the premises was undertaken and it was evident that several bedrooms had been decorated and refurbished in line with service users wishes and one of the home’s bathrooms had also been completely refurbished. Environmental requirements made at the last inspection have now been met. Overall the Home is cleaned and decorated to a good standard with modern furnishing and fittings in keeping with service users preferences. The Home is spacious with a large modern fitted kitchen, large lounge and separate dining room with a conservatory leading to a nicely laid garden with table and chairs. Equipment and training are provided to ensure that good hygiene practices are observed. The Home was cleaned to a good standard and was odour free throughout. Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 The quality of service in this outcome group was judged to be good. Service users benefit from a stable, competent well-trained staff team, who have undergone a rigorous recruitment procedure to ensure their best interests are protected. EVIDENCE: All staff is trained to either level 2 or 3 NVQ and a senior member of staff is being supported to undertake her level 4 award. Records and discussion with staff evidenced that a range of mandatory and service specific training was being undertaken by staff. Training requirements from the last inspection regarding have now been met and an ongoing training programme for staff is now in place. Service users are well supported and the manager and small stable staff team demonstrated an awareness and commitment to their individual needs – and during the time service users were in the home the relationships were observed to be positive with service users demonstrating a confidence in the people who were supporting them. A sample of staff files were seen including those of the most recently employed person. It was evident that a rigorous recruitment process was followed, which ensured that appropriate references and checks were undertaken. Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 19 Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 The quality of service in this outcome group was judged to be excellent. Service users benefit from a qualified, competent and experienced manager, who ensures a well run and accountable management of the service. Service users benefit from having their health, safety and welfare promoted and protected. EVIDENCE: The manager has completed the NVQ 4 Management and Care Award and has several years experience of working with this client group as a support worker and later in a management capacity. Observation on the day, records viewed and discussion with staff evidenced that the manager delivered an effective client led service. She presented as a motivated and enthusiastic leader and staff spoke highly of her and felt that she was approachable and inclusive in her management style. The home’s Quality Assurance System was robust. It regularly sorts the views of service users and other stakeholders and recorded how feedback was sort and acted upon. Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 21 A sample of the home’s generic policies and procedures from the new organisation were inspected and the inspector was impressed with the quality of these. However it was agreed that the manager would now review these to ensure that they met the local needs of service users. Information taken from the homes pre-inspection questionnaire, records viewed on the day of the site visit and observation and feedback gained from the inspection process evidenced that the Home was being maintained and managed appropriately to ensure service users safety and wellbeing at all times. Ridgeway Care Home DS0000066240.V297569.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 Adults 18-65 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 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 X 4 X X 3 X Ridgeway Care Home DS0000066240.V297569.R01.S.doc Version 5.2 Page 23 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. 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. 1 Refer to Standard YA41 Good Practice Recommendations It is recommended that the manager review the new organisations generic procedures to ensure they meet service users local needs. 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