Inspection on 10/04/06 for Ridgeway House

This inspection was carried out on 10th April 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ridgeway House 01/04/08

Ridgeway House 02/04/07

Ridgeway House 14/09/05

Ridgeway House 24/05/05

Ridgeway House 18/01/05

Ridgeway House 17/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Ridgeway House 2-6 The Avenue Lincoln Lincs LN1 1PB Lead Inspector Mr Doug Tunmore Unannounced Inspection 10th April 2006 09:00 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 Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ridgeway House Address 2-6 The Avenue Lincoln Lincs LN1 1PB 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) 01522 530552 Guardian Care Homes (UK) Limited Mrs D Dunn Care Home 32 Category(ies) of Dementia - over 65 years of age (32), Old age, registration, with number not falling within any other category (32) of places Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th September 2005 Brief Description of the Service: Ridgeway House is a care home situated close to the centre of Lincoln and is within easy reach of local facilities, including shops and a post office. It is a converted building with a single storey extension on the ground floor, providing care and accommodation for thirty five people. The home has a refurbishment programme which complies with The Commission For Social Care Inspections standards. The registration is for a care home, providing care for older and for some who have Dementia. The homes statement of purpose states that when people work hard throughout their lives and have committed to helping others, we think they deserve extra cherishing. The home is owned by Guardian Care Homes (UK) Limited and managed by Mrs D. Dunn. Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection. The main method of inspection used was called case tracking, which involved selecting three residents and tracking the care they receive through the checking of their records, discussions with residents, the care staff and observations of care practice. The acting manager was on duty at the time of this inspection. A tour of the premises took place. What the service does well: What has improved since the last inspection? What they could do better: This inspection found that not all senior cares have up to date training in the safe handling and administration of medication. Residents care assessments have not recorded their likes and dislikes relating to all aspects of their daily living. Residents and relatives are not empowered by the homes complaints procedures. Training profiles are not up to date for all cares and the home does not meet NVQ (National Vocational Training) targets of 50 of all staff to be trained to this level by 2005. The home does not carry out regular Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 6 residents/relatives meetings or a quality monitoring system. The home must keep those receipts relating to residents personal finances. An immediate requirement was made relating to an allegation of verbal abuse towards a resident not being addressed by the acting manager, see standard 18. 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 House DS0000002548.V288950.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Residents are admitted into the home only after a full needs assessment has been carried out either by the home or health care or social care agencies. EVIDENCE: The home has a detailed admission procedure, which identifies the needs of residents coming into the home. One visitor stated that she had visited the home prior to the admission of her relative and that the acting manager had also visited her relative prior to admission and carried out a care assessment of his needs. Residents files contained the homes assessment carried out prior to admission and an assessment carried out by a social worker. Files also showed that residents had received a letter from the home confirming that the home could meet their needs. Some residents spoken to at lunch commented that they could remember being visited prior to admission but could not remember receiving a letter from the home. One senior care worker knew about the care needs of residents and was aware of the homes admission procedures. Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Progress is being made in improving care plans to ensure that the general health and welfare of residents is addressed. Not all senior care staff are trained in administering medication. Relatives and residents are encouraged to take part in the plan of care. On the day of the inspection medication was administered appropriately. EVIDENCE: Daily entries had been made in care plans by care staff, which identified the care given. The homes accident book was seen and it was found that accidents occurring to residents have been recorded appropriately in the residents file and body map. Those residents who are able are encouraged to sign their care plans, evidence was seen that either residents or relatives sign care plans. One visitor said that she was aware of her relatives care plan and had gone through it with the key worker and then signed to agree the care provided by the home. The visitor also said that ‘her husband is well cared for is always in his own clothes and looks clean and presentable’. Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 10 The senior carer demonstrated that she had knowledge of the homes personal care policy and confirmed that she had read it and signed to acknowledge that she understood her duties relating to giving personal care to residents. One visiting district nurse stated that ‘in the last six months there has been an improvement in this home, staff are very helpful, communication with the home has improved and carers follow suggestions of care to be given to residents. A tour of residents rooms found that bumpers had not been fitted to bed rails to ensure the safety of residents. The acting manager confirmed that this had not been undertaken but this would be addressed as soon as possible. Files seen confirmed that health care professionals visit the home when required by the residents. Residents confirmed that they have seen the GP when required. The pharmacist inspected the home on the 06/05/05 and recorded that storage and administration records of medication is carried out appropriately. On the day of this inspection medication sheets were found to be in order. However, individual training files seen did not evidence that all senior carers had undertaken a safe handling and administration of medicines course. Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13,14 &15 The home offers a set menu, which is chosen by residents and accommodates individual preferences. Relatives and friends of residents are made welcome in this home. A range of activities are available to residents. EVIDENCE: The home undertakes a variety of activities for the stimulation of residents. The homes notice board showed that on a number of days during the week activities are made available both by the activities organiser and care staff. Over the Easter period there is a raffle, flower crafts, garden club and a Easter Bonnet competition as well as an entertainer visiting the home. Two residents commented that in the summer they go down to the Brayford Pool, which they like very much. The homes activities worker works five days a week undertaking activities from 12.00 pm to 4.00 pm. Both visitors confirmed that they are made welcome at the home. One visitor said that the staff inform me of any changes in my relative which prepares me for the visit. A resident confirmed that she takes her visitors into the ‘Blue Room’ where they are offered a cup of tea. Files seen did not demonstrate that residents are consulted about their likes and dislikes regarding all those aspects of their daily living. Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 12 The inspector joined two residents for lunch and found that meal was hot and very tasty. Both residents commented that the meals are very good and a choice is available. The cook stated that she was aware of residents dietary and had prepared two puddings which were sugar free for lunch. The cook also confirmed that she is to undertake training relating to her post in the near future. Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Residents are not empowered by the homes complaints procedure. Care staff have not undertaken safeguarding vulnerable adults training. The home does not have a robust approach to investigating allegations of abuse. EVIDENCE: The complaints form was seen and it was found that there was not a place for a complainant to sign to signify whether they agreed with the outcome or not. Those residents and relatives spoken to confirmed that they were satisfied with the care provided with a resident commenting that ‘ staff listen to you’. No complaints have been made in 2005 or 2006. The home has Lincolnshire’s Adult protection procedures as well as the homes whistle blowing policy. The senior carer confirmed that she would inform the acting manager if she had any concerns regarding the treatment of residents. She gave an example of a carer being verbally abusive to a resident, which she reported to the acting manager. However, there was no written evidence found regarding this allegation. The acting manager confirmed an allegation had been made and no action had been taken by himself neither did he seek advice from his area manager or other professional bodies. The training file did not evidence that all staff had undertaken adult protection training. Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21 & 26 The home is clean and tidy, with a pleasant smell throughout. Appropriate heating is not available in all rooms. EVIDENCE: The home carried out a maintenance audit with the last one being undertaken on the 05/11/05. The home has a rolling maintenance programme that shows ongoing work carried out externally and internally at the home. A tour of the environment found that the home was reasonably well decorated clean and tidy. All residents files have a individual risk assessment relating to the safety of service users in the homes environment. These risk assessments were more detailed in relation to those service users who were most at risk of falls. One residents en-suite facility was found not to have any heating. This room was cold and the installation of a radiator is required. Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 15 A partial tour of the home by the inspector found it to be clean with no unpleasant odours detected. Residents and visitors alike said that the home is always clean and there are no unpleasant smells. Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): There are sufficient staff to care for the residents. Staff training is now in place and all carers undertake induction training when starting at the home. The home carries out a thorough staff recruitment process. EVIDENCE: Two care workers personnel files were seen and evidenced that appropriate checks are undertaken for the safeguarding of residents. The home has distributed to all carers The General Social Care Council Codes of Practice, which sets out responsibilities as care workers looking after vulnerable adults. The homes training plan was seen and found not to be up to date. The training record in part identified those workers, who had undertaken statutory training in 2004 and 2005. There was also no record of those carers who had undertaken NVQ (National Vocational Qualifications in care training) training. The acting manager commented that five care workers including himself have NVQ (National Vocational Qualifications level 2. The acting manager confirmed that he has level 2 & 3 and has applied to undertake the Registered Managers Award. The training folder showed that some staff had undertaken, Dementia training, first aid, moving and handling, care planning and managing behavioural problems and dementia. Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 17 A senior carer stated that she has NVQ level 2 and had completed the homes induction training. The home has also introduced a Skills For Care induction booklet for all new carers. The homes rota was seen and it was found that adequate staffing levels are maintained to meet the needs of residents. One carer stated that there are always enough staff on duty to cover shifts. Both visitors seen felt that there are enough staff available when they visit. Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33,35,36, & 38 Records seen show that residents’ health and general welfare and safety are not always promoted. The home does not hold regular residents meetings. Quality assurance audits of residents and visitors views are not carried out. Accurate records are kept of residents’ monies. EVIDENCE: The providers are to apply for a ‘fit person’ application for the current acting manager of this home. Due to this no requirement will be made relating to the home not having a registered manager. There was no evidence available to show that the home conducts, on a regular basis, an in-house quality assurance check or report. The home evidenced that in March 05 a family and friend questionnaire was undertaken. These were seen and showed a positive response from those who had completed the questionnaires. However, there was no evidence that the information accrued from this exercise had been published on the homes notice board for the Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 19 information of residents and relatives. Two visitors stated that they had not been asked to complete a questionnaire. The home last undertook a residents meeting on the 05/04/05. Residents spoken to said that the home does not hold residents meetings. Supervision of care staff is not undertaken on a regular basis. Two carers on duty confirmed that they had not undertaken supervision or appraisals. The acting manager confirmed that although there is a list of staff who are to have appraisals or supervision there are no dates for this activity. The home deals with residents personal allowances and receipts are kept of monies paid to the hairdresser or chiropodist. However, receipts for one resident was not available to show how his monies had been spent. All funding is paid direct to the company by standing order or checks. Residents monies were checked against the record of monies held on their behalf and it was found that an accurate record is kept. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. There was also evidence that fire alarm, fire drills and emergency lighting checks and fire alarm inspections have been undertaken. Care staff also receive fire training as part of the homes initial training and as a regular training event. Certificates were available showing that hoists and the shaft lift had not been serviced on a six monthly basis as required. All wheelchairs seen on the day of the inspection had footplates, which were in use. Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 20 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 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 1 3 x 2 x x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 2 X 2 Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? yes 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 OP8 Regulation 13(4)(c) Requirement Bumpers must be fitted to bed rails to ensure the safety of residents. (The timescale of 15/02/06 has not been met). The home must make arrangements for training of all senior carers who administer medication. The home must record residents likes and dislikes relating to all aspects of their daily living. The home must treat any allegation of abuse towards a resident seriously and alert the appropriate authorities. The home must provide safeguarding residents training for all workers at this home, including the acting manager. The home must provide heating suitable for residents in all parts of the home. (Timescale of 15/07/05 not met) with a new timescale being made at the homes additional visit. The home must hold residents and relatives meeting in order to seek their views about the DS0000002548.V288950.R01.S.doc Timescale for action 25/06/06 2 OP9 13(2) 25/06/06 3 4 OP12 OP18 16(m) 13 (6) 25/07/06 10/04/06 5 OP18 13 (6) 25/07/06 6 OP21 23(2)(p) 15/05/06 7 OP33 24 25/06/06 Ridgeway House Version 5.1 Page 22 8 OP33 24 (3) 9 OP35 16(i) 10 OP36 18(2) 11 OP38 23(c) running of the home. The home must undertake an effective quality monitoring system based on seeking the views of residents and visitors with the results of any surveys published for their information. The home must keep an accurate account of residents monies spent by keeping all receipts. The home must ensure that persons working at the home are appropriately supervised. (The timescale of the 15/12/06 has not been met). The home must ensure that all hoists and shaft lift are serviced as required. Lifting Operations & lifting Equipment Regulations 1998. 25/07/06 25/06/06 25/07/06 25/06/06 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 2 Refer to Standard OP16 OP28 Good Practice Recommendations The home should empower residents and relatives by amending the homes complaint form so that they can add their comments regarding the outcome of their complaint. A minimum ratio of 50 trained staff members to NVQ level two excluding the registered manager should be available in the home by 2005. The homes training file should be kept up to date to enable an accurate audit of training needs of carers to be made. 3 OP30 Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ridgeway House DS0000002548.V288950.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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