CARE HOMES FOR OLDER PEOPLE
Ridgeway House Front Street Station Town Wingate Durham TS28 5DP Lead Inspector
Belinda Parker Unannounced Inspection 17th January 2006 08:45a 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 DS0000039753.V266171.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 DS0000039753.V266171.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Ridgeway House Address Front Street Station Town Wingate Durham TS28 5DP 01429 836383 01429 837658 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) Southern Cross Home Properties Limited Care Home 48 Category(ies) of Learning disability (10), Old age, not falling registration, with number within any other category (38) of places Ridgeway House DS0000039753.V266171.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Named Individuals: The home may accommodate named individuals as set out in a letter to the registered person dated 29th December 2004 and 11th May 2005 which establishes the basis on which the individuals` needs will be met by the home. Where necessary the home’s Statement of Purpose shall reflect any changes in service provision required for this arrangement. This condition may not apply to anyone else, other than the named individuals, who fall outside the registered category. 12th July 2005 Date of last inspection Brief Description of the Service: Ridgeway House is registered to accommodate up to 38 older people in the category of (OP) and 10 people with Learning Disabilities (LD). It is not registered to accommodate persons who require nursing care. The home is owned by Southern Cross Homes Proprieties Limited and operates within the private sector. Ridgeway House occupies a prominent location in Station Town, adjoining the main road, close to local amenities and with views over the surrounding countryside. The home is a two-storey building situated in its own private well-maintained grounds. Personal accommodation and communal space is located on both floors. The Learning Disability unit is separate to older persons accommodation but located within the main building. Service areas are located on the ground floor. 35 service users were accommodated on the day of inspection. Ridgeway House DS0000039753.V266171.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 17/01/06 over a period of 3.5 hours. During the inspection the inspector spent time talking to service users, staff a relative. We toured the building and a number of records were examined. There were no outstanding requirements. What the service does well:
Ridgeway House consistently provides a good standard of care to the people who live in the home. The atmosphere on entering the home is warm and friendly. A service user spoken to said it was her choice to come and live in Ridgeway House permanently due to the good care she had received from staff when she had previously spent a short period of respite care in the home. A relative and a service user commented positively with regard to being treated with respect from staff. A service user said staff treat her at all times with respect, commenting, “Staff help me if I want them to, but let me try to do things for myself”. A relative spoken to said, “ The staff treat my mother with respect at all times”. The home provides a varied range and choice of meals with alternatives always being made available to meet individual choices. Comments from a service user and a relative when asked about the quality of the food served included, “ I am comfortable and well fed”, “ I like small meals, but you can get more if you wish”, “ My relative gets good quality food”. All records examined in the home for the protection of service users were accurate and up to date. The environment is clean, bright and accessible. Service users where walking freely along the corridors to other communal seating areas in the home. Ridgeway House DS0000039753.V266171.R01.S.doc Version 5.1 Page 6 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. Ridgeway House DS0000039753.V266171.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 DS0000039753.V266171.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): Standards 2, 3, 4 and 5 The pre-admission and assessment process for this home is clear. The process involves the prospective service user and their supporters. Enabling the prospective service user to make an informed decision as to whether their needs can be met by moving into the home. EVIDENCE: All service users have a Statement of Terms and Conditions of residency. The company has introduced a revised document including the new company name that is to be given to all new and current service users. The administrator said service users or relatives who act on their behalf would be asked to sign as to their agreement. Ridgeway House DS0000039753.V266171.R01.S.doc Version 5.1 Page 9 Three care plans examined included evidence to show that before any prospective service user is admitted to the home, a full assessment of need is carried out. The assessment is carried out by the manager or senior member of staff. To ensure the home has the capacity to meet the needs of the prospective service user. The senior member of staff assisting with the inspection said the service user, their relatives and any other health professional involved in their care is included in this process. A service user who has recently come to live in the home said, her family and social worker had been involved in the pre-admission assessment process. The service user said she wanted to come and live in Ridgeway House and had spent a short period of respite care in the home. As well as visiting and spending time in the home before admission. Ridgeway House DS0000039753.V266171.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 8, 9 and 10 Evidence included in care plans, and discussion with service users’ and a relative showed that staff treat the people who live in the home with respect and adequately meet the health needs of the individual person. EVIDENCE: Care plans examined included information to provide staff with the necessary information to meet the health needs of the individual service user. Care plans are evaluated on a monthly basis to ensure the changing needs of service users are met. Since the last inspection the procedure for recording medication received into the home has been improved. All handwritten entries are signed and witnessed by the staff members responsible for receiving the medication for individual service users. A service user said staff treat her at all times with respect, commenting, “Staff help me if I want them to, but let me try to do things for myself”. A relative spoken to said, “ The staff treat my mother with respect at all times”. It was observed staff assisting a service user to transfer to a wheelchair explained to the person what they were going to do.
Ridgeway House DS0000039753.V266171.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): Standards 12, 13, 14 and 15 The activity programme in the home is limited. This does not provide the people living in the home with a fulfilling social life. Visitors are welcome at any reasonable time. Service users have access to information regarding advocacy services providing them with choices as to how they wish to make their views known. The dietary needs of people living in this home are well met. EVIDENCE: Although there is an activity programme displayed, the range of activities is limited to monthly musical evenings. The Operations manager visiting the home said the company is currently advertising for an activities co-ordinator. The administrator has been given additional hours to carry out a range of activities in the home. A service user spoken to said she enjoyed the recent quiz evening and musical entertainment. The new manager should review and develop the programme of activities in the home to provide service users with an opportunity to participate in a fulfilling social life. A relative visiting said she is always made welcome by the staff. It was observed that all staff passing the room of a service user popped in to say hello to the visiting relative. The relative said staff keep her and other family members informed of any changes to their mother’s care.
Ridgeway House DS0000039753.V266171.R01.S.doc Version 5.1 Page 12 The home has information available of an independent advocacy service. This information is displayed in leaflet format and easily accessible to service users, should they wish to have someone speak on their behalf to make their views known. There is a four-week rotating menu in place. Offering a range of varied dietary choices. A service user spoken to said she did not like fish but she is always offered an alternative of her choice. Comments from service users and a relative included, “ I am comfortable and well fed”, “ I like small meals, but you can get more if you wish”, “ My relative gets good quality food”. The dining area is spacious and comfortable. Tables are appropriately set. The Operations manager said, if a service user requires a special diet advice will be sought from a dietician. Care plans included evidence of a nutritional assessment having been carried out that is reviewed on a monthly basis. To ensure the dietary needs and choices of service users are being met. Ridgeway House DS0000039753.V266171.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): Standards 16 and 18 Evidence is available to show that service users views of the service delivery are listened to and acted on. Robust recruitment and training processes are in place to ensure the people living in the home are protected from abuse. EVIDENCE: The home has a clear and comprehensive complaints procedure in place. This procedure is displayed in the home and sets out the time scales for the process. Evidence is available to show that all complaints are recorded in the complaints book and the outcome documented. There have been no recorded complaints since the last inspection. Staff training profiles examined included a record to show that individual staff members’ had attended POVA training (Protection of Vulnerable Adults). Criminal Records Bureau check had been carried out for all staff employed in the home. To ensure service users are protected from harm or abuse. Ridgeway House DS0000039753.V266171.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): Standard 19 The external environment has been improved, providing a safe walking area to the rear of the building for service users and visitors. The home has been developed to admit 10 people with Learning Disabilities who require residential care. EVIDENCE: Since the last inspection the paved area to the rear of the building has been levelled to prevent the risk of falls or trips. The home has been redesigned internally to include a unit covering two floors for 10 people with a Learning Disability, who require residential care. No disruption has been caused to the people who already live in the home. The company is currently recruiting additional staff and developing a staff training programme to equip senior staff and new care staff with the necessary skills to meet the needs of people with Learning Disabilities. Ridgeway House DS0000039753.V266171.R01.S.doc Version 5.1 Page 15 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): Standards 28 and 30 Staff are given the necessary training relevant to their role of responsibility to adequately meet the needs of the service users living in the home. EVIDENCE: The home has a training programme in place. That includes training for staff who will work in the new unit designed for people with Learning Disabilities, living in a residential setting. Staff files examined contained individual training profiles. All training attended is recorded and a copy of certificates for courses completed included in personal profile. The home continues to work towards all care staff achieving NVQ2 in Care. Ensuring all staff has the necessary skills and abilities to meet the needs of the people living in the home. Ridgeway House DS0000039753.V266171.R01.S.doc Version 5.1 Page 16 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): Standards 31, 33 and 38 The home is currently managed in an efficient and effective manner. Ensuring that a safe environment is maintained for the safety of the people who live, work and visit the home. EVIDENCE: Since the last inspection a new manager has been appointed, who will commence in post 18/01/06. The Operations manager said the new home manager is experienced in working with older people and people who have Learning Disabilities. On the day of the inspection appropriate management arrangements were in place. Staff spoken to said they where looking forward to the new manager commencing in post. Ridgeway House DS0000039753.V266171.R01.S.doc Version 5.1 Page 17 The home has a quality assurance and quality monitoring system in place. Ensuring the home is being run in an effective and efficient manner. Systems are in place to give service users and other visitors to the home the opportunity to make their views known e.g. meetings, satisfaction questionnaires and comments/complaints procedures. A quality audit is carried out by the manager and Operations manager monthly. A copy of the Operation’s manager’s Reg 26 report is received by CSCI monthly. Health and safety records examined showed that major systems and disability equipment in the home is serviced and maintained for the protection of service users, staff and other visitors to the home. Ridgeway House DS0000039753.V266171.R01.S.doc Version 5.1 Page 18 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 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 X STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X X X X 3 Ridgeway House DS0000039753.V266171.R01.S.doc Version 5.1 Page 19 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 2 Standard OP31 OP12 Regulation 8,9 and 10 16 (m) (n) Requirement The new manager must apply for registration with the Commission for Social Care Inspection. The registered person must develop the activity programme in the home to provide a varied and fulfilling social life for the people who live in the home. Timescale for action 01/03/06 31/03/06 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 OP19 Good Practice Recommendations The registered manager should ensure the paved seating area to the rear of the building is flat in identified areas to prevent trips and falls. Ridgeway House DS0000039753.V266171.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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