Inspection on 01/05/07 for Ridgewood

This inspection was carried out on 1st May 2007.

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

Ridgewood 22/02/06

Ridgewood 01/09/05

Ridgewood 23/02/05

Ridgewood 10/08/04

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 Ridgewood 54 Mount Pleasant Road Camborne Cornwall TR14 7RJ Lead Inspector Richard Coates Key Unannounced Inspection 1st May 2007 09:15 Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 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 Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 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. Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ridgewood Address 54 Mount Pleasant Road Camborne Cornwall TR14 7RJ 01209 710799 01209 714624 alison@mjbridgewood.co.uk 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) Matley-Jones Brown Ltd Sally Peacock Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th June 2006 Brief Description of the Service: Ridgewood is a detached house situated in a residential area of Camborne. The Registered Provider is Matley-Jones Brown Ltd. Mrs A Brown is the Responsible Individual and Ms Sally Peacock is the Registered Manager. Ridgewood is registered to provide accommodation and care for up to twelve adults with a learning disability. The aim of the registered provider is to accommodate service users with more complex needs. The statement of purpose states that the intended age group is between 30 and 65 on admission. All the bedrooms are single. They are situated on both the ground and first floor. The accommodation on the first floor is for physically able service users. All bedrooms have their own toilet and hand basin; some have their own bath. One entrance provides access to wheelchair users; the ground floor is on one level. The communal rooms are on the ground floor. There is a spacious and secluded garden. The home is within walking distance of the town centre and local facilities. Cornwall Adult Social Care Department commissions day activities for some service users, and the provider arranges day activities for other service users as part of their packages of care. The fees were in May 2007 ranged from £741.35 to £1153.39 weekly. Fees are based on an assessment of the prospective resident’s needs. Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a planned unannounced inspection to inspect against the key national minimum standards as identified by the commission, and selected other standards. The provider submitted a pre-inspection questionnaire before the inspection visit. The inspector spent time at the home over two days inspecting records and documents, touring the premises and having discussions with the registered manager, staff, residents and some relatives. The commission also sent surveys to residents and to their relatives and representatives. What the service does well: Ridgewood provides comfortable and homely accommodation for twelve service users with sufficient staff to meet their needs and respond to individual preferences. Prospective residents and their representatives receive wellpresented informative material to support them in making a choice about the home. The provider has developed user-friendly material with pictures and simple language. The provider obtains copies of needs assessments from the commissioning agencies involved with prospective residents. Staff from the home visit prospective residents and carry out their own assessment to ensure that the home can meet their needs. Care planning and risk assessment are thorough and detailed so that staff have clear and specific written directions on how they should meet the needs of residents. Relatives stated that the home staff kept them up to date with important issues and care planning. The provider is proactive and thorough at monitoring and addressing the residents’ healthcare needs. The records for individual residents are well maintained. The staff are effective in supporting service users to make choices and decisions about their daily lives. They support residents to participate in a range of weekday activities and social activities, according to their individual needs and preferences, and to enjoy ordinary valued living in the community. Residents informed the inspector that staff supported them in making decisions. They appreciated the staff’s helpfulness and kindness. Staff interact with residents in an appropriate positive and adult manner. Residents reported that staff were sensitive when assisting them with personal care, and they felt safe when care was being delivered. Residents told the inspector that they enjoyed their meals and got to eat their preferences and favourites. Residents have their own rooms, which reflect their individual preferences and interests, spacious shared areas and a secluded and secure garden. The home is clean, hygienic and well maintained. Staff receive all required training and are encouraged to pursue their own personal development. The staff have a high level of NVQ qualification. The manager is qualified, maintains and updates her skills and knowledge, and the staff have confidence in her. Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 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 Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The provider’s policy and practice ensure that prospective residents and their representatives receive well-presented information about the home in order to make an informed choice. The needs and aspirations of residents admitted to the home have been effectively assessed, so that the provider could be sure that the home could meet their needs. EVIDENCE: The commission has recently granted an application from the provider to increase the registered numbers at the home to 12. The statement of purpose has been revised to reflect this change. The home has admitted two new residents since the last inspection. The provider had obtained detailed assessment and care planning information from the commissioning authority, Cornwall Department of Adult Social Care. A member of the home’s staff had also completed written needs assessments for these residents. The records showed that residents had made trial visits to Ridgewood in order to meet the staff and residents, and see the home. Both residents have received service user guides with photographs and simple language text. A social care Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 9 professional reported that the home had managed the admission of a new resident very well. The registered manager reported key workers had gone through the accessible service users guide and complaints procedure with each resident and this would be repeated. Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The written care plans reflect the changing needs and personal goals of residents. The plans direct and inform staff in detail so that they provide effective individual care and support. Staff support residents to make decisions and take risks as part of an independent lifestyle. EVIDENCE: We case tracked three residents’ records. Care plans are signed and dated and cover the residents’ assessed needs very thoroughly. Each had a detailed care plan based on a ‘strengths and needs’ assessment. The care plan sets out in detail for staff, for each area of this assessment, the need, the intervention required and the desired outcome. A further format details specific goals for each resident with the actions required by the resident and care staff to Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 11 achieve these goals. Plans include supplementary information particular to each individual and specific records suited to the care needs of each individual. Residents have signed their care plans and have contributed a record of their personal views, “All about me”. A resident who spoke to us was clearly well informed about his care plan. Reviews were documented with planned dates for future reviews. There were detailed risk assessments, which document, where appropriate, agreed restrictions on choices and freedom. Relatives stated that the home staff kept them up to date with important issues and care planning. The registered manager discussed how the staff involve residents and their representatives in reviews of their care plans. Each resident has an identified key worker. Staff complete daily records of activities and events which are signed and dated. The care plans set out the residents’ lifestyle preferences. The registered manager discussed examples where support was provided in decision-making. Daily records and observation provided evidence of staff supporting residents to make decisions in day-to-day matters – for example activities and outings, choices of food and drink. Residents informed the inspector that staff supported them in making decisions. They appreciated the staff’s helpfulness and kindness. Staff demonstrated warm, skilled and effective communication with residents during the inspection. The residents case tracked had advocates arranged through an advocacy service. The responsible individual is appointee for benefits for four residents, where there appears to be no other appropriate person to take on this role. Risks are assessed before admission as part of the assessment and admission process for each resident. The residents’ records case tracked contained detailed risk assessments for activities and other areas of risk. The assessments directed staff in specific interventions to control the identified risks. The registered manager discussed a number of examples where residents were supported to take responsible risks. There is a missing service user procedure. Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff support residents to take part in individually planned social and leisure activities in the home and in the local community. Residents eat a varied diet and enjoy their mealtimes. EVIDENCE: Residents attend a range of weekday activities as part of their individual care packages commissioned by Cornwall Adult Social Care and the registered provider. These activities include Camborne College, the Murdoch and Trevithick Centre at Redruth, the John Daniel Centre at Penzance, Oasis rural activity centre, the Mustard Seed Café, Boscawen Farm and other placements. Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 13 Ridgewood is in a residential street within walking distance of the town centre. Residents use local shops and cafes in Camborne, and visit other towns. The home has a vehicle for transporting residents. A resident went out for lunch and shopping with a staff member in Camborne on the day of the inspection. Two other residents went riding at a local stable and out to lunch. The home provides television, DVD, video and music equipment. Residents have their own televisions and music centres in their rooms. There is a computer for residents in the conservatory. Games and jigsaws are available. Residents have their own varied individual leisure interests and preferences. One resident enjoys reading. He has a good selection of books and is supported to use the local library. One resident’s room is set up and decorated as a sensory room, and he has an electronic percussion system. Another resident is interested in horses and dogs, and her room and leisure activities reflect this. There is an ‘open door’ for visiting, although visitors are asked as far as possible to integrate with residents’ lifestyles, preferences and planned outings. Residents can see their visitors privately in their own rooms or in shared areas such as the conservatory and the garden. One resident’s visitors said that they were regularly offered tea when they visited the home. A number of residents have regular arrangements for spending time with their families away from the home. Residents have general freedom of movement around the home and grounds. The garden is secluded and secure. When staff are not in the kitchen with residents, it is locked to protect their safety. Residents can lock their room doors from the inside; staff can override this if necessary. Residents can also lock their rooms, if they wish to, when they go out. Residents’ choices about joining in activities are respected. The residents’ participation in housekeeping and personal tasks is set out in their care plan and related to their abilities, preferences and personal action plan. There is a smoking area on the patio outside the back door. Ridgewood meets a range of needs in relation to food and diet. Breakfast is generally cereal, toast, juices and drinks. The midday meal on weekdays for residents not out of the home attending activities is a sandwich, soup or a savoury snack. Tea is the main meal of the day on weekdays, and examples of recent menus were spaghetti bolognaise, and quiche with salad and jacket potatoes followed by pudding, yoghourt and fresh fruit. The menus for the midday meal and tea are swapped at weekends. Residents told the inspector that they enjoyed their meals and got to eat their preferences and favourites. Staff know the residents’ likes and dislikes. Where appropriate, staff complete nutritional assessments, and allergies and specific dietary needs are clearly recorded. One resident requires food to be liquefied and assistance with eating. The manager and staff provide healthy eating menu choices and advice. The last food hygiene inspection by the environmental health officer Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 14 was on 27 April 2006. This identified no legal requirements and reported that the premises were very clean and tidy. Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents’ preferences and views are taken into account when staff assist them with personal care. The manager and staff are very attentive in ensuring that the residents’ often complex health care needs are met. The home’s policies and procedures for the management of medicines protect residents, with clear written guidance for staff. EVIDENCE: Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 16 The support for residents with their personal care and healthcare follows a person centred approach. The residents’ care plans set out in detail the assistance they need with their personal care, their areas of independence and how staff can support them in their independence. The plans include the individual’s preferences and choices in relation to personal care. Residents have designated key workers. A social care professional stated that the key worker system, in her experience, worked well. One resident currently requires intensive assistance with personal care involving the use of equipment. The staff are suitably trained and competent to deliver this care. The registered manager reported that the GP has recently reviewed the care arrangements for this resident’s and was very satisfied. The provider has also obtained advice and guidance from the appropriate clinical specialist and the community nurses. All service users have their own toilet, and curtains have been installed for those who may not close the door. The mix of male and female care staff is reasonable given the need for assistance with personal care of the eight female residents. Residents reported that staff were sensitive when assisting them with personal care, and they felt safe when care was being delivered. Care is conducted in privacy. Residents choose their own clothes with some guidance as to weather conditions and proposed activities. Staff support residents to shop for their own clothes. Residents were wearing modern clothes appropriate for their age. Residents go to a hairdresser in Camborne. Relatives reported that they were very satisfied with the standard of care provided. The records provided evidence that the registered person ensures that the residents’ healthcare needs are assessed, recognised and addressed. All residents are registered with a GP. Staff record detailed contact records for all appointments and treatment with GPs, community nurses, clinical specialists, consultant psychiatrists, chiropodists, dentists, opticians and other healthcare services. Care plans and directions for staff for the residents’ healthcare needs are well developed and detailed. One parent commented that her son’s healthcare needs were at last being properly assessed and addressed. There is a policy and procedure on the handling of medicines and the registered person has a copy of the Royal Pharmaceutical Society guidance. Medicines are stored in a locked cupboard in the dining room/sitting room. This is not a cabinet of the required standard, but the registered manager said that the provider had decided to purchase a standard steel double locking medicines cabinet soon. Residents sign a written consent to the administration of medicine. No residents are currently assessed as safe to self-administer their medicines. There were no controlled drugs reported as in use at the time of the inspection. The provider uses the Boots monitored dosage system. The administration records document the checking of medicines on receipt, the administration of medicines and their disposal. The medication administration records folder contains photographs of residents. Patient information leaflets are retained in individual files, with supplementary information about the medicines prescribed. The medication administration records were well Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 17 maintained, showing no missed signatures in the sample examined. Changes to the prescription for individual residents are dated and referenced. A random check of a sample of medicine’s dosage and stocks against the medication administration record showed these to be accurate. No medicines past their expiry date were found. Where residents are taking medicines prescribed as ‘when required’ there was very clear written guidance for staff on the circumstances in which medicines were to be administered. The pharmacist had visited the home and signed an agreement for advice on 26 March 2007. Staff who administer medicines have completed a course in the safe handling of medicines. Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The provider’s complaints procedure, which is also available in a pictorial and simple language version, should ensure that the views of residents and their representatives should be listened to. The arrangements for the protection of vulnerable adults safeguard residents. EVIDENCE: The provider has a written complaints procedure which complies with the standard and the regulation. Residents receive a pictorial and simple language version. Residents and their representatives reported that they knew how to make a complaint. Residents said that the registered manager and staff were kind and approachable, and they had confidence in them. The pre-inspection questionnaire recorded that there have been no formal complaints since the last inspection. The provider has a written policy and procedure on adult protection and has issued easy to understand guidance for staff. The provider has obtained from Cornwall Department of Adult Social Care a copy of the revised multidisciplinary vulnerable adult protection procedures. There is a useful flowchart posted on the office notice board, which summarises the procedure. The registered manager provides staff with introductory training and refresher Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 19 training in the safeguarding of adults. The majority of staff have completed the multi-agency alerters’ or foundation training. The remaining staff are planned to attend this in future months. The provider has made one referral under the procedures during the year to Cornwall Department of Adult Social Care, which leads on safeguarding adults. Appropriate actions were taken. The responsible individual is appointee for benefits for four residents. There is a written record detailing the payments of the home’s fees, signed by two staff. The home holds personal allowance money for all residents. The staff maintain weekly records of money received and spent, with receipts. At the end of each week the balance is carried forward to the next week. The cash is kept securely as individual balances. Two of these cash balances were checked against the record and found to be accurate. Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a comfortable, clean and well-maintained home, which provides a safe and suitable environment. EVIDENCE: The home is situated in a residential area of Camborne, within walking distance of the town’s facilities and shops. The main entrance is on the side of the premises. This entrance has a step. Wheelchair users can access the building from the car park through another entrance on the front of the building. The ground floor is on one level. There is a flight of stairs to the first floor, so that the rooms on this floor are suitable for physically able residents. Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 21 There has been an increase in registered numbers to 12 since the last inspection. The additional bedroom has been created on the first floor. The office has moved up to the first floor and the quiet lounge/activity room has relocated to the ground floor. The registered manager hopes that residents will now make more use of this room. The shared spaces now comprise the large sitting room/dining area and conservatory with its dining area, and this activity room. Some parents and relatives understandably had concerns about the further expansion of the home, but it does not appear to have detracted from the services and facilities provided. One social care professional felt that the layout of the home might restrict the residents’ leisure time choices. There is a patio area outside the back door and a secluded and secure garden. The premises are well maintained and in good decorative order. The home was comfortable, bright and cheerful with no untoward odours. Residents, their relatives and staff all reported that the home was kept clean and fresh at all times. All the lighting that was checked was working. Furniture is of good quality and domestic in style. One resident was pleased with her new bedroom furniture, which was delivered during the inspection. There is a maintenance programme with records. The provider and the staff has made great efforts to personalise residents’ bedrooms and each room reflects the resident’s interests and lifestyle preferences. The furniture and fittings reflect the needs and preferences of each resident. One resident who has complex care needs has the equipment needed for the safe and effective delivery of her care. Staff have made her room into a very comfortable and pleasant living area. Residents expressed satisfaction with the accommodation and facilities. All bedrooms have their own individual identified toilet and hand basin in a separate room. Some rooms on the first floor also have their own bath. There is a level entry shower on the ground floor, and a bathroom on the ground floor with a powered assistance seat. All the bathrooms, toilets and basins inspected were clean and hygienic. The laundry is a separate room with a ceramic tiled floor accessed from the ground floor hallway. There are two washing machines and two tumbler dryers. These are domestic standard. The staff manage some incontinent clothes and linen. They reported that this is sluiced before being laundered. There is a policy and procedure for infection control and written guidance. There are hand-washing facilities for staff with liquid hand wash and paper towels in the kitchen, and at other points. Gloves and aprons were available around the home. Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team is effective in providing support and care to residents. Recruitment practice is safe, and has protected the well being of residents. Staff complete appropriate training to meet the needs of residents. EVIDENCE: The Residential Forum model for calculating staffing levels applies to Ridgewood, as a home that has been first registered since April 2002. The current staffing level meets that set by the model. The staff roster details all staff on duty, including the registered manager and ancillary staff. This information is set out for residents daily on a pictorial board in the ground floor hallway. The provider aims to have four staff on duty during the daytime, with two waking staff at night. Levels of staffing allow reasonable flexibility in supporting residents in their preferred activities and outings. There are currently no trainee staff under 18. Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 23 The registered manager discussed the process of recruitment and selection of staff. Applicants are invited to the home for an interview, a look around and to meet residents. Staff support the residents to meet the applicants and ask questions, so that their views can be obtained. The records of recent staff recruitment contained structured application forms and interview records with standard questions. The provider had obtained two references, Criminal Records Bureau disclosures, identity information, and copies of qualification certificates. There were, however, no photographs for the most recently recruited staff, as these were still in the camera. The provider issues statements of terms and conditions to staff. The registered manager maintains a summary training record for all staff detailing the training completed and the training planned. Each staff member has an individual training record. The induction training is based on the common induction standards set out by ‘Skills for Care’. The records sampled for one member of staff contained a completed workbook with detailed written exercises. A second member of staff stated that her induction had been very thorough and was an excellent preparation for the work. She had completed all required training and her NVQ level 2 and level 3. There is a rolling programme of training in moving and handling, intervention techniques, health and safety, first aid, food hygiene, adult protection, and fire safety. Eleven out of the current 14 care staff have NVQ at level 2 or above. This is close to an 80 rate of qualification. Staff reported that the training and opportunities for their personal development were very good. They felt effectively supervised and supported to do their jobs well. A social care professional stated that the staff here were committed to their work. Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is very effectively managed to fulfil its aims and objectives and to meet the needs and aspirations of the residents. There are sound arrangements to ensure the safety and welfare of residents and staff. EVIDENCE: Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 25 Sally Peacock was registered as the registered manager in January 2007. Alison Brown is the responsible individual. There are clear lines of accountability for these roles. The registered manager’s post has a job description which details the manager’s responsibilities. The provider drew up an updated business plan in January 2007. The registered manager has completed the registered manager’s award. During the last year she has completed training in equality and diversity, and health and safety. She also updates her knowledge through her membership of the Association for Real Change. Sally Peacock reported that the staffing level allows her sufficient time to carry out her management role when she is on duty. She understands the importance of being an excellent role model for staff. The home’s records are maintained to a very high standard. Staff reported that Sally Peacock and Alison Brown are very approachable, and respond to, and resolve, their questions and concerns. Staff said that the management communicate a clear vision for the culture of the home and for the standards of care and support to be provided. A health care professional stated that the registered manager had recently worked creatively and enthusiastically to address the issues in a resident’s care arrangements. A social care professional reported that the culture in the home was very good, with a progressive attitude that embraced good practice. The provider has strengthened the management structure has by appointing two deputy managers to replace the previous team leader posts. The deputy managers will both undertake the NVQ level 4 in management. There is a quality management policy and procedure. A quality survey has been carried out in the last year through questionnaires to relatives and representatives. The responses indicate a high level of satisfaction with the services and facilities. The provider is intending to repeat this exercise annually. Staffs have regular 1:1 meetings with each resident, which are recorded. Staff use an ‘activity evaluation record’ to record the outcomes of activities with service users. These records provide useful information when care plans are being reviewed and developed. There is a policy on accident reporting. The inspector examined the accident records. There has been a low level of reported accidents in the last year. The provider issues a statement of health and safety policy to all staff setting out the corporate and individual responsibilities. All staff complete training in basic health and safety. An identified member of staff leads on health and safety and carries out a monthly health and safety audit of the premises. The last health and safety inspection carried out by the environmental health officer was in April 2006, when no actions were required. The registered manager has drawn up a fire safety risk assessment. The last visit by a fire officer was on 1 November 2006. This inspection identified some areas of non-compliance in the signage of fire doors and the fitting of storage cupboards with fire doors. The provider has confirmed that the required actions have been taken to address these matters. The fire records detailed the required regular checks on the alarm system, emergency lighting, and Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 26 extinguishers. Staff receive regular training in fire safety. The fire procedures are posted at strategic points around the home. Fire exits have a list of service users and a floor plan posted. Detailed COSHH information is available on hazardous substances. The inspector checked against the original documents a sample of the comprehensive list of maintenance and safety records provided on the preinspection questionnaire and found them to be satisfactory. Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 27 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 3 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 4 X 3 X X 3 X Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 28 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 Ridgewood DS0000034044.V337004.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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