Inspection on 22/02/06 for Ridgewood

This inspection was carried out on 22nd 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

Ridgewood 01/05/07

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 Unannounced Inspection 22nd February 2006 09:15 Ridgewood DS0000034044.V277917.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 Ridgewood DS0000034044.V277917.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. Ridgewood DS0000034044.V277917.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ridgewood Address 54 Mount Pleasant Road Camborne Cornwall TR14 7RJ 01209 710799 01209 714624 alison@mjbridge.wood.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 Mrs Alison Jean Brown Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Ridgewood DS0000034044.V277917.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user only may be accommodated outside of the home`s main category. 1st September 2005 Date of last inspection 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. Mr P Brown is the Responsible Individual and Mrs A Brown is the Registered Manager. Ridgewood is registered to provide accommodation and care for up to ten 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 age group intended is between 30 and 65 on admission. The home provides ten single bedrooms. These are situated on both the ground and first floor. 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. There is a range of spacious communal rooms on both floors. One entrance provides access to wheelchair users and the ground floor is on one level. 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. Ridgewood DS0000034044.V277917.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a planned unannounced inspection to review compliance with the key national minimum standards in the areas of care planning, lifestyle and the premises. The last inspection report, dated 1 September 2005, included the standards not included in this inspection. The inspector spent over seven hours at the home, inspected records and documents, toured the premises and had discussions with the deputy manager, staff and residents. The inspector wishes to thank the staff and residents for their assistance in completing the inspection. What the service does well: What has improved since the last inspection? Staff are using appropriate codes to record the reasons when they do not administer medicines, ensuring the accuracy and completeness of the medication records. The office has been moved to a larger room providing more space for the secure storage of documents, and allowing the previous office to be used for the freezer and dry goods store. Ridgewood DS0000034044.V277917.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. Ridgewood DS0000034044.V277917.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 Ridgewood DS0000034044.V277917.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): 1, 3 and 4 Prospective residents and their representatives receive information about the home in order to make an informed choice. The provider obtains assessments and carries out their own assessment in order to determine if they can meet the prospective residents care needs. EVIDENCE: The home had very recently admitted a new resident. The provider had obtained detailed assessment and care planning information from the resident’s previous care setting. Staff had visited the prospective resident and carried out an assessment. The resident’s key worker had drawn up an initial outline care plan to guide and direct staff. The resident had made a trial visit to Ridgewood in order to meet the staff and residents and see the home. The deputy reported that key worker had gone through the accessible service users guide with the resident and would do this again. Cornwall Department of Adult Social Care had provided detailed information about one area of the resident’s care needs, but had not provided a summary of the social care assessment or care plan before the admission date. Ridgewood DS0000034044.V277917.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 Detailed care plans reflect the changing needs and personal goals of residents. EVIDENCE: The care plan for one resident case tracked consisted of an eight-part detailed care plan, a record of his strengths and needs, and a current action plan. The plan clearly directs and informs staff about how they should meet the resident’s needs and preferences. Daily records are consistently recorded, legible, factual and signed. Staff maintain records for specific behaviours in order to inform and support the work of specialist workers and the consultant. The last review was in November 2005; the next was planned for May 2006. Care planning documentation is dated and signed. The resident had also signed the record. The home retains separate detailed contact records for all the agencies and services that each resident is involved with. Ridgewood DS0000034044.V277917.R01.S.doc Version 5.1 Page 10 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): 12, 13, 15, 16 and 17 Service users have opportunities for personal development and take part in a range of appropriate educational, social and leisure activities. Service users are supported to make choices about their meals, 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. One resident whose records were case tracked attends two rural farming and craft centres and has a regular weekly outing and activity with a local support agency. Other residents attend Camborne College, the Murdoch and Trevithick Centre at Redruth, the John Daniel Centre at Penzance and local work placements. The deputy manager reported that the social worker for the recently admitted resident was visiting the home on the following day to discuss and plan weekday activities. The home is in a residential street within walking distance of the town centre. Residents use local shops, public houses and cafes in Camborne and visit other towns, for example Truro and Penzance. The home has a vehicle for Ridgewood DS0000034044.V277917.R01.S.doc Version 5.1 Page 11 transporting residents. Residents and staff discussed where they had been recently and what they enjoyed doing. One resident discussed her shopping trip on the day before the inspection. Another resident went shopping with a staff member in Camborne on the day of the inspection. One resident has expressed an interest in, and voted in, recent elections. The home provides television, DVD, video and music equipment in the two sitting rooms. Residents have their own televisions and music centres in their rooms. There is a computer for residents in the conservatory. Residents were engaging in art and craft activities during the inspection. Games and jigsaws are available. Residents have their own varied individual leisure interests and these are evidenced in their individual rooms. One resident enjoys reading and 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 time reflect this. The deputy reported that residents attended a pantomime after Christmas. Activities outside the home have been somewhat reduced during the cold winter months; the deputy manager discussed the visits to beaches and tourist areas that took place during the summer. There is essentially 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. 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. The deputy manager stated that mail for residents is given to them and not opened by staff. 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. Ridgewood is a no smoking home and there is a smoking area on the patio outside the back door. Ridgewood has to meet 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 attending activities is sandwich, soup or a savoury snack. Tea is the main meal of the day on weekdays, and examples of recent menus had been roast pork, pizza and chicken curry, with 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 Ridgewood DS0000034044.V277917.R01.S.doc Version 5.1 Page 12 to eat their preferences and favourites. Staff know the residents’ likes and dislikes. Dietary needs, preferences and allergies are recorded. The residents have varied needs in relation to diet. Some have to be careful about their overall intake, and others need to be encouraged to eat an adequate and nutritious diet. The home is meeting some specific dietary needs, for example a dairy free diet. One resident requires food to be chopped and assistance with eating. Residents tend to eat in their preferred small groups – for example in the main dining area and in the conservatory, but can also eat in their rooms. The inspector enjoyed a lunch with some residents and this was a relaxed occasion with individual choices of menu. Ridgewood DS0000034044.V277917.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 and 20 There are arrangements for meeting the residents’ physical and emotional health needs to ensure their continued wellbeing. The management of medication protects residents. EVIDENCE: Records evidence that residents’ healthcare needs are monitored and addressed. Staff keep detailed contact records for all healthcare professionals and services. All residents are registered with local GPs. Daily records and correspondence document the monitoring and addressing of residents’ healthcare needs and referral to appropriate healthcare professionals and specialist workers. Care planning and documentation in respect of the healthcare needs of individual service users are well developed and detailed. In one recent example where the registered manager and staff have significant concerns about the healthcare needs of a resident, they have contacted and involved appropriate agencies and specialists. The home uses the Boots monitored dosage system for medicines. The policy and procedure covers the required areas. Medicines are stored in a locked cabinet in the main lounge/dining area. Residents sign a form of consent to the administration of medication where they have capacity to understand this. No residents currently administer their own medication. Staff check and sign in the medicines received from the pharmacist. Records of administration Ridgewood DS0000034044.V277917.R01.S.doc Version 5.1 Page 14 were consistently signed, with appropriate codes being entered for reasons for non-administration – for example absence from the home. Amendments to a resident’s prescription are recorded in detail on a ‘Change of Medication record’. Residents’ records include information for staff about the medicines they are taking. There are no controlled drugs in current use and no examples of the administration of medicines by specialised techniques. The policy and procedure would need a section to be added were the home to admit residents requiring the administration of medicines by specialised techniques. Staff who administer medicines have completed a course in the safe handling of medicines. Care plans did not consistently provide written guidance for staff on the circumstances in which they should administer ‘as required’ medicines. The deputy manager stated that the use of ‘as required’ medicines was thoroughly discussed at staff meetings. However, to ensure consistency in the use of ‘as required’ medicines, this guidance should be provided clearly in writing. The last visit for advice from the pharmacist was just over a year ago, and the deputy manager undertook to address this. Ridgewood DS0000034044.V277917.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): 23 The arrangements for the protection of vulnerable adults safeguard residents. EVIDENCE: The provider has issued easy to understand guidance for staff on the protection of vulnerable adults. There is a useful flowchart for alerters. The provider needs to obtain from Cornwall Department of Adult Social Care a copy of the revised multi-disciplinary vulnerable adult protection procedures. The home’s guidance requires minor amendment to link into the revised procedures. The majority of staff have completed the multi-agency alerters’ training. Four remaining staff are booked to attend this in future months. The home holds personal allowance money for all residents. The registered manager is appointee for benefits for four residents. The staff maintain weekly records of money received and spent with receipts. An 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.V277917.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, 26, 27 and 30 The service users live in a comfortable and well-maintained home which provides a safe and suitable environment and meets their needs. 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 where physically able residents have their rooms. The premises are well maintained and in good decorative order. The shared spaces comprise a large sitting room/dining area and conservatory on the ground floor, and a large lounge and activity room on the first floor. There is a patio area outside the back door and a secluded and secure garden. The home exceeds the space requirements set in the standards for homes registered after April 2002. The home was comfortable and cheerful with no untoward odours. All lighting checked was working. Furniture is of good quality and domestic in style. A fire risk assessment has been completed. There is a maintenance programme with records and staff complete a regular health and safety walk through with a checklist. Ridgewood DS0000034044.V277917.R01.S.doc Version 5.1 Page 17 Residents’ bedrooms are personalised to each individual occupant and reflect their interests and lifestyle preferences. The rooms contain furniture and fittings which generally meet the standard, and also reflect the needs and preferences of each resident. One resident who has more complex care needs has the equipment needed for the safe and effective delivery of her care. Residents were pleased to show the inspector their rooms and expressed satisfaction with the accommodation. 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. The home is clean and in good decorative order. All the bathrooms, toilets and basins inspected were clean and hygienic. The laundry is a separate room accessed from the ground floor hallway with a ceramic tiled floor. There is a policy and procedure for infection control and written guidance displayed in the laundry. There are hand washing facilities for staff with liquid hand wash and paper towels in the kitchen and in the staff toilet. Gloves and aprons were available around the home. Ridgewood DS0000034044.V277917.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): These standards were included in the last announced inspection report. EVIDENCE: Ridgewood DS0000034044.V277917.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): These standards were included in the last announced inspection report. EVIDENCE: Ridgewood DS0000034044.V277917.R01.S.doc Version 5.1 Page 20 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 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLES Standard No Score 11 X 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 X X X X X X X Ridgewood DS0000034044.V277917.R01.S.doc Version 5.1 Page 21 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. 1. Refer to Standard YA20 Good Practice Recommendations Care plans should give staff clear guidance on the circumstances in which ‘as required’ medication should be used. 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