Inspection on 30/06/05 for Ridgeway House

This inspection was carried out on 30th June 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 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 24/02/06

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 Karen Walker Unannounced 30th June 2005 09:30 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ridgeway House Address 143 Highridge Green Bishopsworth Bristol BS9 3JR 0117 9645054 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) Ms Elaine Leslie Miss Alivia Susan Peacock PC Care home 7 Category(ies) of LD Learning disability (7) registration, with number of places Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 7 persons, aged 18 - 64 years, requiring personal care. Date of last inspection 15-Mar-2005 Unannounced 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 D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Discussions were held with the manager, two staff members and three residents. Records relating to residents were examined and key-workers explained the care planning process and individual needs. Other records were examined relating to the health and safety, and general running of the home. What the service does well: What has improved since the last inspection? Residents are better protected by the homes adult protection policy that is based on the ‘No Secrets’ in Bristol DOH document. The manager ensures that staff are made aware of and comply with standards of conduct and practice set by the General Social Care Council (GSCC). Residents’ benefit from a staff team that understand not only their own roles and responsibilities, but also those of their teammates. Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.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 D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 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 standard(s) 1,2 Prospective residents have the information needed to make an informed choice about where to live. They also have the opportunity to stay for trial periods. EVIDENCE: These standards were not fully assessed however at the last inspection it was seen that 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 manager said the admissions policy was being further developed but details were available in the statement of purpose. It was noted that residents’ assessment of needs were in place and the relevant funding authority regularly reviewed these. Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 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 standard(s) 6,9,10 Residents are supported to take appropriate risks as part of an independent lifestyle; however, without adequate reviews taking place independence could be compromised. EVIDENCE: Care plans were examined and it was noted that the relevant referrals had been made to ensure changing needs were met. The Bristol Intensive Response Team (BIRT) had given support for one resident whose behaviour is sometimes challenging. It is recommended that an ABC chart be put in place to monitor the challenging episodes, this information can then be used to identify any triggers that may have caused the behaviour. Information regarding challenging behaviour was clearly recorded in the careplanning folder. Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 Page 10 The key-worker was knowledgeable of this resident’s needs and strengths and had attended various training sessions to ensure he offered the appropriate support. Risk assessments were examined and it was noted that one assessment instructs staff to stay with a resident whilst he baths. There have however been significant changes to this resident’s needs and other documentation refers to ‘no seizures’ for over two years. The risk assessment is reviewed as ‘no change’. The care plan reviews also document ‘no change’ when there has been significant change. It is a requirement that care plans and risk assessments are appropriately reviewed and reflect current needs and progress. The home has a missing person policy. There is a description of each resident in care records giving personal information including height, colour of hair and weight and an up to date photograph. These are to be used if a resident ‘goes missing’. Staff members were aware of the confidentiality policy and when it would be necessary to invoke the protection of abuse policy. Records were stored appropriately. Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 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 standard(s) 11,12,13,14, Residents’ are given opportunities and support for personal development and are able to be a part of their local and wider community. EVIDENCE: Care plans 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. Activity plans demonstrated that residents’ were supported to attend college to increase skills and build on interests. Activities were reviewed with the resident and the organisers to ensure that they remained relevant to the individual. Five of the residents were at the hydrotherapy pool when the inspection began; they were supported by three staff members. Residents’ confirmed they enjoyed the session. Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 Page 12 One staff member said residents are involved in menu planning and in the daily running of the home. It was confirmed by residents that they use local community facilities, which include dentist, opticians, chiropodist and allied healthcare professionals. Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 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 standard(s) 19,20 Residents’ are able to gain the support they need to ensure their medical and healthcare needs are met. EVIDENCE: Referrals were seen for relevant professional input including sensory assessments, speech and language therapy and input from the Bristol Intensive Response Team (BIRT). It was noted that all residents had a ‘Waterlow’ assessment carried out. The assessments seen indicate that residents were at a very low risk of developing ‘pressure areas’ therefore it is recommended that these assessments are discontinued unless a ‘high risk’ has been identified. One resident with epilepsy has an excellent ‘epilepsy file’ with an intervention and management plan. All staff fully record all seizures seen including a description and length of the seizure. This is good practice. Professional visit forms are currently used to document all professional input however they do not record the ‘outcome’. The manager said that new forms have been devised that will ensure more detail is included. The inspector at the next inspection will review this. Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 Page 14 The medication system in the home was examined alongside a random selection of records. These were satisfactory. The medication administration record was clearly written and signed appropriately. There was a record of medication entering and leaving the premises. There was a photograph of resident and a medication profile including a list of side effects. There is a homely remedy protocol for residents’ signed by the general practitioner. This is good practice. The home has a medication policy. This was viewed at the last inspection. Medication was stored appropriately in a cupboard attached to the wall. There were records that demonstrated that all staff have attended medication training with a local chemist. A random selection of medication was checked against records and found to be correct. The manager stated that the home completes weekly audits on medication held in the home. Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 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 standard(s) 22,23 Residents are supported by a staff team who have their best interests in mind. Fuller training around the ‘protection of adults’ will further enhance staff awareness and ensure resident safety. EVIDENCE: One staff member was aware of the ‘No Secrets’ in Bristol DOH document and how it linked with the homes ‘protection of adults’ policy. Some staff had only received abuse awareness input as part of their National Vocation Qualification and in light of one residents ‘challenging behaviour’ it is required that all staff attend ‘abuse awareness training’. It was further recommended to the manager that ‘abuse awareness’ training be sought from Bristol Social Services. This is a free service available to the whole staff team and provides up to date information on recognising and responding to a suspicion of abuse. The staff member spoken with said he attended a ‘people first’ seminar which went through the importance of ‘advocacy’ and ‘empowerment’. He was able to describe the various types of abuse and placed importance on not de-skilling people. All residents have access to the complaints procedure and staff confirmed that the manager was approachable and would take all complaints seriously. One resident said ‘I would say if not happy’. Positive interactions were observed between staff and residents. Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 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 standard(s) The last inspection report demonstrates that residents live in a homely, clean environment that meets their needs. EVIDENCE: These standards were fully assessed at the last inspection and so were not assessed on this occasion. The house was clean and tidy on the day of inspection and rooms were bright and welcoming. Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35 Residents are at risk of harm from untrained staff with regards to statutory training. Residents are supported by the homes robust recruitment policy. EVIDENCE: The manager stated that three members out of six have completed an NVQ 2 or 3. The deputy is in the process of completing an NVQ 4 along with the registered manager. The manager stated that they are in the process of completing the NVQ assessor’s award. The manager explained that an external assessor visits the home on a four weekly basis. It was noted that staff members attend some training sessions relevant to residents needs and one staff member was able to explain the needs of her key-person with regards her religion and specific support needs. It was noted that not all-statutory training was undertaken in a timely fashion. A letter was seen from the Responsible Individual reminding staff to ‘stop lifting’. It is a requirement that all staff attend manual handling and any other statutory training needed and updates are sought in a timely fashion with records kept. This was highlighted at the last inspection and will be subject to enforcement if legislation is not followed with the required timescales. Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 Page 18 One staff member was very aware of the needs of his key-person in relation to his autism. It was noted that this staff member had done his own research into this subject, which is good practice. He and the team would benefit from a structured ‘autism training course’ and this is strongly recommended. Staffing records were examined and staff confirmed they completed forms to enable a Criminal Record Bureau check to take place. All staffing records were in place as per legislation. Team meetings are held on a regular basis and residents’ needs and support mechanisms are discussed. Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,40,41,42,43 Residents benefit from a well run home where their best interests are protected. EVIDENCE: Two staff members made positive comments on the management style. One staff member said ‘the manager is very good, easy to talk to and fair. She always tells us what we need to know’. The Avon Fire Brigade visited the house in May 05 and were satisfied with the procedures in place. The fire logbook was examined and all appropriate checks are taking place on a regular basis. The manager stated that ‘In-house’ policies and procedures are in the process of being rewritten and reviewed. Relevant policies and procedures were in place including the ‘Protection from abuse’ policy. This needs to be slightly adapted to ensure regulation 37 notifications are sent appropriately. Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 Page 20 There was a current certificate of insurance and registration certificate in place. The Commission for Social Care Inspection is receiving copies of monthly provider visits in respect of regulation 26. The business accounts were not seen on this occasion. The manager stated that they have an allocated weekly amount to spend on food and staffing is planned around the needs of the residents’. Additional staff are employed on a regular basis to provide residents’ with opportunities to go out socially especially in the summer. This was evidenced through the staff roster held in the home. The manager was keen to commend the provider on her support and commitment to providing a quality service. The manager stated she regularly meets up with the provider. Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 3 3 3 3 x x x Standard No 31 32 33 34 35 36 Score 3 2 2 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ridgeway House Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 3 3 D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 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. 1. Standard 6 Regulation 17(3)(a) Requirement It is a requirement that care plans and risk assessments are appropriately reviewed and reflect current needs and progress. the team to attend Protection of Vulnerable Adults training. It is a requirement that all staff attend manual handling and any other statutory training needed and updates are sought in a timely fashion with records kept. Timescale for action 1/08/05 2. 3. 23 32 13(b) 18(1)(i) 1/10/05 1/10/05 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. 2. 3. 4. Refer to Standard 6 19 23 33 Good Practice Recommendations put in place ABC charts as neccessary discontinue waterlow assessments attend ‘abuse awareness’ training provided by Bristol Social Services. all staff to attend a training course/session on autism Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 Page 23 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI Ridgeway House D56_26614_RidgewayHse_227085_210605_Stage4.doc Version 1.30 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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