Inspection on 24/02/06 for Ridgeway House

This inspection was carried out on 24th February 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ridgeway House 28/11/06

Ridgeway House 30/06/05

Ridgeway House 15/03/05

Ridgeway House 28/07/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Ridgeway House 143 Highridge Green Bishopsworth Bristol BS13 8AB Lead Inspector Wendy Kirby Unannounced Inspection 24th February 2006 09:30 Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 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 DS0000026614.V283920.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 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 House DS0000026614.V283920.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ridgeway House Address 143 Highridge Green Bishopsworth Bristol BS13 8AB 0117 9645054 NONE 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) Ms Elaine Leslie Miss Alivia Susan Peacock Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 7 persons, aged 18 - 64 years, requiring personal care. 30th June 2005 Date of last inspection Brief Description of the Service: Ridgeway House is registered with the Commission for Social Care Inspection (CSCI) to provide accommodation and personal care to seven adults with a learning disability aged between 18-64 years of age. Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the annual inspection process. The inspector spent some time with the deputy manager, examining three residents care files and records relating to the day-to-day management of the home. The inspector spoke with and observed three members of staff and had a tour of the home. The inspector enjoyed having lunch with all six residents in the home. Feedback was given at the end of the inspection. What the service does well: What has improved since the last inspection? Care files were able to show the inspector that plans had been reviewed and updated to reflect resident’s current needs. A training plan has been developed to address mandatory training requirements and other courses, which will enhance the care they deliver to the residents. A course in manual handling has now been completed. Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 Page 6 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 DS0000026614.V283920.R01.S.doc Version 5.1 Page 7 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 House DS0000026614.V283920.R01.S.doc Version 5.1 Page 8 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 Resident’s needs are assessed to ensure the home is suitable to meet individual requirements. EVIDENCE: The home has one vacancy and has an established group of residents. This standard was not fully assessed on this occasion however the home has a statement of purpose and a service user guide. The documentation was comprehensive and accessible to residents. The documentation included symbols and pictures. The admissions policy was being further developed. Care files examined showed that needs had been assessed pre-admission to the home and contained information to determine the suitability of the placement and that needs could be met. Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 Page 9 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): 6,7,8,10 Staff have a good awareness of individuals needs and treat the residents in a warm a respectful manner, which means that they can expect to receive care and support in a sensitive way. EVIDENCE: Staff on duty were able to demonstrate a clear in depth understanding of residents individual needs. Through observation and discussions with the staff the inspector witnessed skills of sensitivity and warmth when communicating and delivering care to the residents. The residents at Ridgemead have complex needs with varying impairments and learning disabilities. Staff were able to inform the inspector of individual communication requirements and explained that only two residents can communicate verbally. Through patience and time they have identified methods of communication with other residents, for example one resident is able to alert staff that she is hungry by going into the kitchen. Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 Page 10 Each resident has a personal portfolio and person centred assessments, which means that staff put the views, wishes, likes and dislikes of each resident at the centre of all care provided. The information for each resident was informative and useful enabling staff members to provide the appropriate care to support their health and social needs. From the assessments staff had identified needs enabling them to form written care plans. These were written clearly and concisely and in a sense that the residents and relatives had contributed in the implementation of plans. Families are invited in writing to participate in six-monthly care reviews. Where possible staff had gained a signature from the resident. Health plans were in the process of redevelopment in picture format in order to assist residents in identifying their needs and understanding how these needs will be met. All records were stored appropriately. The deputy manager informed the inspector that they had tried to hold residents meetings, but found that the residents were more comfortable and responded better by meeting on a one to one basis. The residents smiled at the inspector throughout her visit and the atmosphere in the home was calm and relaxed. Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 Page 11 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): 11,12,13,14,15,16,17 Residents enjoy a range of activities and are supported to live a fulfilling life in and out of the home. Residents are supported and encouraged to maintain firm connections with families and friends. Residents take an active role in promoting and maintaining a healthy well balanced diet. EVIDENCE: Daily routines and activity plans were discussed which included attending college and various day centres on weekdays. Care plans and discussions with staff demonstrated that the home was providing residents’ with opportunities to develop social, emotional, communication and independent living skills. There was information on the levels of independence and the level of support that was required by staff to support the individual in and outside of the home. Documentation was able to indicate those residents who enjoyed taking part in household chores for example hovering and washing up. Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 Page 12 Activities were reviewed with the resident and the organisers to ensure that they remained relevant to the individual. All individual tastes and preferences were taken into account. One resident did not enjoy being around lots of people and therefore when going to shows, musicals and pantomimes the staff would always book a box for her to sit in. One resident was an “Abba” fan and went to regular tribute concerts, one resident enjoyed comedy and recently enjoyed a trip to the Hippodrome to see the “Chuckle Brothers”. Some residents enjoy singing karaoke, however one resident really dislikes it so staff arrange the session when the resident is out. It was evident that staff respect the residents right to choice and support this at all times. Several outings are arranged each month and shows such as “Peter Pan” and “Jungle Book” have already been booked. When the weather permits day trips are organised to suit all needs for example, a picnic would be arranged because one resident likes food, it would be in a place with nice walks to please another resident, and a place where there would be animals to suit another resident needs. Holidays are also organised to suit individuals, one resident likes to holiday on her own with the support from one carer, another enjoys the magic of “Disney Land”, and two residents prefer beach holidays. Family and friend contact is encouraged and supported whereby the residents invite people for lunch or tea and some resident’s stay with their families for weekend visits and holidays. One resident’s father visits most Sundays and stays for lunch. The home has a mini bus to enable residents to enjoy going out further a field. The inspector had lunch with all six residents, which was relaxed and unhurried. Two residents required assistance with feeding and this was done in a supportive sensitive way. The lunch was savoury rice stuffed peppers with fruit for pudding; there was good supply of squash with the meal. This dish was n new choice on the menu, which had been devised with the residents. Each Sunday staff meet with each resident individually to discuss what the residents feel about the food and whether they would like to suggest an alternatives. This system enables the residents to make their own choices and with the support of the staff it was evident from the menus that they have produced a varied healthy diet plan. Alternatives were also made available and flexibility in meals was evident. The kitchen was clean, tidy and well equipped. The stores, fridge and freezer had a good supply of food Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 Page 13 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): 19,20 Residents are supported to ensure that their healthcare needs are met. There are safe systems of practice in receiving, storing, administering, and disposing of drugs. EVIDENCE: Residents care files provided evidence that residents were referred to appropriate health professionals within a multi disciplinary team. Following the previous inspection the staff consulted with the community physiotherapist with regards to discontinuing the Waterlow charts. It was agreed that some residents were at a low risk of developing pressure sores and that the charts could be discontinued, however two residents needs had indicated that it would be good practise to continue with the charts. All visits and outcomes to the General Practitioner and any other professionals are recorded to provide a history and quick reference guide Staff training records indicated that members have received training in physical and emotional health related issues for example “who’s challenging who” and “First Aid”. Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 Page 14 Policies and procedures for receiving, storing, administering and disposing of medications were examined and correct. There were photographs of each resident on their medication charts to help ensure that medication was dispensed to the correct person. The administration charts were legible and continuity of administration was shown with a signature from the person dispensing Medication stocks for drugs prescribed are checked and recorded fortnightly. The General Practitioner provides six-monthly medication reviews. Staff had received training in “medication Competency”. Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 Page 15 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 Residents are supported by staff that have their best interests in mind, there is a detailed complaints policy and procedure in the home. Training is provided to help protect residents from harm or abuse. Policies and procedures in the home for the Protection of Vulnerable Adults (POVA) further protect the residents. EVIDENCE: The inspector looked at a newly developed policy and procedure on complaints, which detailed what constitutes a complaint, how the process works and how outcomes are achieved and recorded. The home has not received a complaint in the last year. Residents concerns are logged in individual care files. The policy and procedure is available for visitors in the home and kept in the conservatory. Due to limited communication skills of those living in the home the staff rely on their expertise and knowledge of the residents to recognise if they are unhappy and may have concerns. The inspector also read the policy and procedure for the POVA, which had recently been reviewed and rewritten. The procedure clearly indicates what procedures should take place should abuse be suspected. Since the previous inspection all staff have been enrolled on a course in training for POVA. Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 Page 16 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): 24,25,26,28,29,30 The home provides a comfortable environment ensuring individual needs are met. EVIDENCE: The living room was spacious and provided adequate seating for all residents to sit comfortably in the lounge together and visually everyone could see the television. The residents had a video recorder and DVD player and various videos and DVD’s were viewed offering a varied choice to meet individual tastes. The dining room could accommodate all residents comfortably at the same sitting and was clean and tidy. All six residents bedrooms were looked at and expressed individual choices in colours, fabrics and layout. Residents had accessorised their rooms with memorabilia, soft toys, photographs and ornaments. Residents have televisions, stereos and such like to enable them to spend quality time alone. Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 Page 17 The kitchen was well equipped, and cupboards, fridges and freezers showed a variety of food. Food opened in the fridge had been labelled the date of opening which indicated that staff and residents make every effort to ensure safe handling of food. There was a separate sink to wash hands prior to preparing food with soap and hand towels. All bathrooms, toilets and shower rooms were clean and tidy. The home is appropriately adapted to meet the needs of the residents living at the home. Specialist equipment is in place for one residents identified needs including profiling bed and ceiling hoist. Staff were responsible for keeping the home clean and tidy, residents are also involved with domestic tasks. Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 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): 35 Training arrangements will now enhance a greater skill mix of staff to provide the residents in the home with good standards and quality of care. EVIDENCE: Following the previous inspection the home has devised a training plan for all mandatory requirements and other courses, which are relevant to the residents needs. Staff have now received all mandatory training and are enrolled on courses for POVA and Food Hygiene. As previously mentioned in the report staff are also attending a course entitled “who’s challenging who” and the inspector saw evidence that the deputy manager was looking at courses to improve staff awareness on autism. Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 Page 19 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): 37,42,43 The home is well managed ensuring that resident’s interests and rights are protected by a knowledgeable and experienced staff team within a safe environment. EVIDENCE: The home and atmosphere within was calm and relaxed throughout the duration of the inspection. Staff on duty had demonstrated throughout, their understanding and expertise in identifying and managing the residents individual needs. The residents were relaxed and happy. The deputy manager was competent, able to assist the inspector throughout the visit and confirmed her ability within her role effectively and efficiently. Following several discussions she confirmed her dedication to the staff and residents in the home and shared several initiatives she would like to develop and expressed how much she was enjoying the challenges within her role. Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 Page 20 Some of the Health and safety records in the home were examined. Documentation showed that all relevant checks were maintained correctly and at the required intervals including all fire alarms and equipment, emergency lighting and the water temperatures. Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 Page 21 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 3 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 3 26 3 27 X 28 3 29 3 30 3 STAFFING Standard No Score 31 x 32 X 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 x 3 X X X X 3 3 Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 Page 22 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. Refer to Standard Good Practice Recommendations Ridgeway House DS0000026614.V283920.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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. 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