Inspection on 24/05/05 for Ridgeway House

This inspection was carried out on 24th May 2005.

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 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 10/04/06

Ridgeway House 14/09/05

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 Doug Tunmore 24 th Unannounced May 2005 at 13:00 am 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 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 C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ridgeway House Address 2-6 The Avenue Lincoln Lincs LN1 1PB 01522 530552 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Guardian Care Homes (UK) Limited Mrs D Dunn Care Home (CRH) 32 (Thirty Two) Category(ies) of Dementia - Over 65 (DE(E)) - 32 (Thirty Two) registration, with number Old Age (OP) - 32 (Thirty Two) of places Ridgeway House C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 18th January 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 staement 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 C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 13.00 hours and was carried out as the first of two statutory inspections for 2005/2006. The main method of inspection used was called case tracking, which involved selecting two residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observations of care practice. A partial tour of the premises took place. Two visitors were spoken to one being a district nurse. What the service does well: What has improved since the last inspection? A detailed record relating to the general health care needs of residents is now maintained. This includes the introduction of new policies relating to the intimate care of residents and maintaining their privacy and dignity. The home has installed a hoist in one bathroom and a new bath. Ridgeway House C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 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 C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Ridgeway House C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 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 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. Written confirmation that the home can meet a prospective residents needs has not always been carried out by the home. EVIDENCE: The home has a detailed admission procedure, which identifies the needs of residents coming into the home. One resident said that she was visited prior to admission by someone from the home. The second resident had an assessment undertaken in another authority by the Social Services Department. Files seen showed that one resident had been written to confirming that the home could meet her needs, but the second resident had not received a similar letter. Two care workers spoken to knew about the care needs of residents and were aware of the homes pre-admission assessment procedures. Ridgeway House C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 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 standard(s) 7,8,9 & 10 Progress has been made in the recording of intimate and health care needs of residents. Further work needs to be undertaken in ensuring that accidents are recorded appropriately and good communication is fostered with health care professionals. EVIDENCE: All residents have detailed care plans, which described their health and welfare needs. Care plans outlined risk assessments, nutritional and dependency assessments. Daily entries had been made in care plans by care staff, which identified the care given. However, one accident to a resident was found not to have been recorded on his body map, as per the homes policies and procedures. The visiting community nurse was spoken to who said that ‘residents look well cared for, they have good skin integrity and their nails and general hygiene needs are undertaken’. One issue raised was poor communication on occasion when members of staff ‘ did not follow instructions regarding dressings which had not been replaced, nor was the nurse made aware that this needed to be attended to’. One resident spoken to said that she ‘uses the taxi to go to the eye clinic or her G.P’. None of the current residents administer their own medication. The pharmacist inspected the home on the 06/05/05 and recorded that ‘ storage and administration records of Ridgeway House C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 Page 10 medication is good’. Only senior members of staff administer medication; training was undertaken by one senior carer on the 4/09/04. The homes intimate care policy was seen and found to address the rights, privacy and dignity of residents. The two carers spoken to were unaware of this policy, it was found that the homes induction process did not cover the intimate care needs of residents. Ridgeway House C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 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 standard(s) 13,15 Relatives and friends of residents are made welcome as are visiting health care professionals. Meals are well managed and menus reflect a balanced diet. Residents likes and dislikes are not recorded in writing for the cook. EVIDENCE: The inspector joined three service users for tea, they said that the food at this home is varied and well prepared. Menus were inspected and found to offer choices for all mealtimes. The homes pre-assessment forms were seen and included residents’ dietary needs. Service users files seen did not always evidence their likes and dislikes in the pre-admission assessment form. This information is not made available to the cook for his information. Observations made by the inspector were that staff are at hand in adequate numbers to help and encourage service users to eat their food. Two visitors seen during this inspection commented that they are always made welcome in the home and refreshments are made available. Service users who were spoken to confirmed that ‘their friends and relatives are made welcome when they visit’. The homes signing in book was seen and showed that visitors attend this home in numbers at various times of the day. The homes activity organiser was spoken to and said that during the summer a garden fete and barbeque is held for residents and relatives. The homes diary showed that the Ridgeway House C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 Page 12 manager is taking a resident to another county in August 05 so that she can attend a family wedding. Ridgeway House C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 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 standard(s) 18 The home takes the issue of protecting residents from harm very seriously and has a comprehensive adult protection policy. EVIDENCE: The two carers spoken to were aware of the homes ‘Whistle Blowing’ policy and spoke knowledgeably about abusive practices and what action they would take if this came to her attention. One of the two carers also confirmed that he had received adult protection training three weeks ago. The home now needs to acquire the local authorities updated adult protection procedures. The four residents spoken to confirmed that they felt safe in the home. One resident said that ‘ she felt safe as she pressed the nurse call alarm by mistake and staff came very quickly’. Ridgeway House C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 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 standard(s) 21,24 & 26 The home is reasonably well maintained and there are enough toilets and bathing facilities for residents. EVIDENCE: A tour of the environment found that there were enough toilets, bathrooms and a walk in shower for the needs of residents. However, on testing the water temperature in bedrooms 16, 26 and 29 it was found that there was no hot water to the sinks for residents to wash or shave. The homes audit check on the hot water was undertaken on the 20/05/05 and the water tested in these rooms were recorded as 36 degrees centigrade 42.5 degrees centigrade and 45 degrees centigrade. Room 16 en-suite facilities did not have a radiator, which needs to be fitted for the comfort of the resident. Aids and adaptations are available in bathroom/toilets. Since the last inspection a new bath and a bath hoist has been installed. The two visitors spoken to said that the residents/relative always look well cared for being clean and well dressed. One resident spoken to said that ‘she takes a shower in the privacy of her en-suite facility’. The second resident commented that ‘she Ridgeway House C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 Page 15 never has to wait to go to the toilet or bathroom’. Those rooms seen had locks on doors some being double action locks, which are unsuitable. The manager is to take advice from the owners regarding the planned installation of userfriendly door locks. The home employs three domestic workers who in total work 56 hours per week. No unpleasant odours were detected during this inspection. Those residents and visitors seen confirmed that the home is always clean and tidy with no unpleasant odours detected. The environmental health officer visited on the 21/03/05 and commented that ‘ Training undertaken on food hygiene for all staff has be done to a good standard’. An inspection of the kitchen found that food was appropriately covered and fridges and freezers seen showed that various foods were also covered. Ridgeway House C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These outcomes were not looked at. EVIDENCE: Ridgeway House C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These outcomes were not looked at. EVIDENCE: Ridgeway House C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 2 COMPLAINTS AND PROTECTION x x 2 x x 2 x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x x x x x x x Ridgeway House C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 Page 19 yes 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. 1. Standard 3 Regulation 14(d) Requirement The home must write to prospective residents informing them that the home can meet their needs or not. The home must record all those accidents to residents in line with the homes policies and procedures. (Timescale of 17/05/04 not met) The home must inform all staff of the homes intimate care policies through the induction process. The home must ensure that residents both receive the necessary treatment from health care professional and that good communication is maintained. The home must ensure that residents dietary needs are made available to the kitchen staff in writing . The home must ensure that there are provided at appropriate places in the premises sufficent numbers of wash-hand basins, baths and showers fitted with hot and cold water supply. (Timescale of 25/05/04 not met) The home must undertake a regular audit of the environment Timescale for action 15/07/05 2. 8 17(a) 15/07/05 3. 10 12(4)(a) 15/07/05 4. 8 13(b) 15/07/05 5. 15 12(2) 15/07/05 6. 21 23(2)(j) 15/07/05 7. 21 16(2) 15/07/05 Page 20 Ridgeway House C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 8. 24 12(4)(a) 9. 21 23(2)(p) and address any malfunctioning of facilities. (Timescale of 25/05/04 not met) The home must fit user-friendly locks to residents doors.(Timescale of 16/09/04 not met) The home must provide heating suitable for residents in all parts of the home. 16/09/05 15/07/05 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 Good Practice Recommendations Ridgeway House C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 C53 C04 S2548 Ridgeway House V223828 240505 Stage 4.doc Version 1.30 Page 22 - 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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