Inspection on 24/05/06 for Ridgewood House

This inspection was carried out on 24th May 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 House 11/07/07

Ridgewood House 16/01/06

Ridgewood House 27/07/05

Ridgewood House 05/01/05

Ridgewood House 02/06/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Ridgewood House 13 Dukes Drive Newbold Chesterfield Derbyshire S41 8QB Lead Inspector Brian Marks Announced Inspection 24th May 2006 09:00 X10015.doc Version 1.40 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 House DS0000020084.V296418.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ridgewood House Address 13 Dukes Drive Newbold Chesterfield Derbyshire S41 8QB (01246) 237333 01246 220205 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) Mr Peter Walsh Ms Lorraine Cocking Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Plus Two (2) Day Care Places Date of last inspection 16th January 2006 Brief Description of the Service: Ridgewood house is a detached building located in a busy residential area on the outskirts of Chesterfield town centre. The home is registered for 21 residents aged 65 and over. There are local amenities and bus routes nearby. Accommodation is provided on two floors, and a chairlift is used for residents unable to use the stairs. There are 14 single rooms, two of which have en suite toilet facilities, and three double rooms. The home has three adjacent lounge areas on the ground floor and a separate dining area, with communal toilets close to them. There is one bathroom on the ground floor fitted with aids and adaptations and also a bathroom and a shower room on the first floor. There is a resident call systems fitted throughout the home. There is a small garden/sitting area at the rear of the home as well as benches provided at the front of the home. The home has a no smoking policy. The weekly fee for accommodation at the home is £350. Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection that took place at the home over a period of 7 hours. Additionally, time was spent in preparation for the visit, looking at previous inspection reports and other relevant documents and preparing a structured plan for the inspection. At the home, apart from examining documents, care files and records, time was spent speaking to the owner and the manager and 6 of the staff working at the home during the visit. The care records of 3 people who use the service were examined and 2 of these were interviewed, although they had mild dementia and their comments were broad in nature. Three visitors who were at the home during the morning were also spoken to. What the service does well: What has improved since the last inspection? The manager has carried out all the requirements made at the last inspection which were in relation to carrying out reviews of care plans to ensure that staff are working with up to date information, revision of the home’s staff supervision policy to reflect the agreed arrangements for supporting and monitoring staff in their work and the fitting of appropriate locks to all toilets and bathroom doors to improve resident privacy. Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 6 Additionally a new carpet had been fitted in the upstairs corridor and the patio and garden area has been rebuilt to improve resident safety and access. 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 House DS0000020084.V296418.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The care needs of people coming to the home are properly looked at so that they can be reassured that the home is suitable for them to live in. EVIDENCE: All of the care records examined at this inspection contained initial assessments of the needs of residents with further additional assessments of areas of risk such as safe moving and skin breakdown and pressure sores. These allowed for the development of staff caring activity in a planned way, although some of the latter – ‘risk assessments’ – had not been revised for some time and may be based on out of date information. From discussions with residents and the visitors present, people wanting to come and live at the home are give opportunities to visit before coming to stay, as part of the assessment procedure. The home does not offer an intermediate care service so Standard 6 does not apply. Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Care planning and risk assessment records promote safety and consistency in caring for residents and their health, social and personal care needs are met. EVIDENCE: The care records of 2 residents were examined in detail and 1 other was looked at briefly. Each has a service user plan in place and all are completed to the same good standard, including 1 resident who had been recently admitted to the home. It was also noted that residents or their representative are made aware of the contents of their care plan or had been consulted in their writing up. It was stated that the key worker reviewed the plans on a monthly basis and any changes to a residents needs were amended; it is indicated at the end of each care plan when this has taken place. Records showed that residents have routine access to health care services including chiropody, district nurse and GPs and records of any visits are maintained. A nurse and a doctor visited the home during the inspection. Residents are assessed to identify their risk of developing pressure sores and all have their weight monitored on a monthly basis. It was stated that there Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 10 were no residents with pressure sores at the time of the inspection. All residents or their relatives spoken to commented that staff care for them in ways that respect their dignity and privacy and this was underpinned by entries in the care plans examined. Examination of the arrangements for the receipt, storage and administration of medicines to residents indicated these to be generally satisfactory. Medication is stored securely and there is a lockable refrigerator to store medication, although the daily record of its temperature was not available for examination. The manager handwrites the medication administration records, rather the other ‘blister pack’ systems available, and this has led to a very secure system of medicines administration; all entries are properly checked, signed and dated. There were no controlled drugs being administered at the home at the time of the inspection. All senior staff, as well as the manager, have undertaken medication training from an external source. Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are encouraged to take part in activities at the home and are encouraged to maintain good contacts with family and friends. Standards in the kitchen have been maintained, and residents appreciate the quality of meals. EVIDENCE: Activities and appropriate lifestyles are encouraged at the home, and a care assistant has responsibility for organising these, although all staff are involved, mainly in the afternoons and evenings. The activities record indicated that activities arranged included dominoes, sing-alongs, bingo, quizzes, movement to music, hairdresser (who was in the home during the inspection) and manicure. Staff said that sometimes residents were difficult to motivate. Residents and relatives are able to air their views about activities and events at a home at the regular meetings held with the home’s management. People spoken to stated that routines around the home are flexible and that residents are able to please themselves around the home, within the limits of safety. Contact with families is encouraged through an ‘open door’ policy, and good numbers were seen at the home during the inspection. Those spoken to were positive about relationships with the home’s staff ‘I’m always made welcome, Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 12 it’s like one big extended family’. ‘My key worker or the manager always keep us informed about anything that happens’. During a visit made to the kitchen and from discussion with the cook it was evident that good standards in the catering service have continued, with all the recommendations made at the last visit by the Environmental Health Officer dealt with. A clear choice was available at the main meals, according to the records maintained in the kitchen, and this was conformed by comments from the relatives spoken to, who were very positive about the quality of food served. Special arrangements are made by the cook for people with dietary needs, including people with diabetes and those who need softened food. Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There is a clear complaints procedure for residents and their representatives to use, and staff and management of the home protect residents from harm. EVIDENCE: There is a written complaints procedure available for residents and visitors, although the manager stated that there had been no complaints since the last inspection. She described a very open attitude in her dealings with relatives and advocates and encourages them to speak openly about any issues that they may have. The relatives spoken to confirmed this and reported that they are comfortable in approaching the home’s management at any time and are confident that they will always be listened to. All staff have recently had training with an outside organisation in relation to the protection of vulnerable people and those staff spoken to were aware of the issues and their responsibilities around this matter. The manager was able to demonstrate a pro-active approach to and clear understanding of this subject, developed from previous experiences. The home’s practices concerning residents’ money are satisfactory, and there is safe storage of money and valuables. The home encourages families to look after individuals personal allowances if the resident was unable to do so themselves, and there are clear records of all money accepted on behalf of the resident from families, and of all monies spent on the residents behalf. Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Standards of maintenance, cleanliness and hygiene of the home have been continued the needs of residents are met by its physical arrangements. EVIDENCE: From a tour of selected bedrooms and the communal areas and kitchen of the building, the standard of maintenance was found to be good with areas of the home having been recently redecorated. The proprietor described a planned programme of continued redecoration and upgrading of carpets and furnishings with the services of a contractor regularly available. Since the last inspection new carpets have been fitted to the upstairs corridor and the patio and garden area has been rebuilt to improve resident safety and access. There are three lounge areas, and residents can choose where they wish to sit. Although the dining room is small, there is adequate seating for all residents who regularly take their meals their unless they are sick. The home had a no Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 15 smoking policy and any residents admitted are informed of this. There is one resident that smoked, and she has agreed to smoke outside. Within bedrooms residents have lockable drawers and doors can be locked from the inside with an outside override if this necessary. The manager has consulted with residents on an individual basis concerning their wish for an individual key for their room but no residents have requested this. All the bedrooms visited had very tasteful, matching colour schemes for fabrics and furnishings and the residents and relatives spoken to were very favourable about the comforts of the home. Toilet and bathroom locks were checked and all have now been fitted with an appropriate lock, as required at the last inspection. Recommendations from the last inspections by the Environmental Health and Fire Officers had been carried out although the latter had not visited for some time. Cleaning standards and hygiene of the home were high on the day of the inspection and the person on housekeeping duties spoke clearly about how this standard is maintained. Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The staff group is well-trained, experienced and competent and staff are on duty in good numbers; this makes sure residents needs are met. EVIDENCE: Staffing arrangements have continued on the same basis and there are always three staff on duty in the daytime and two staff on duty at night. As there continued to be a high number of residents that had mild dementia at the home, the manager has planned dementia awareness training for staff. Most staff had worked at the home for a good number of years, from observations and discussion it was clear that staff were dedicated and committed to their jobs. One relative said that ‘They are absolutely brilliant’ and that ‘They pull out all the stops especially when she is ill’. All of care staff, apart from the 2 recently appointed have successfully undertaken NVQ level 2 Care and 5 senior carers also have NVQ level 3 Care. This is well above the target requirements of 50 and should be commended. All staff have recently completed training around the protection of vulnerable adults and dementia awareness training has been planned for the near future. Staff also receive updates in all the core health and safety topics on an annual basis. All the staff spoken to felt that there was a high commitment to their continued development on the part of the home’s management, and that standards of resident care is improved by doing so Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 17 There had been 2 new staff appointed since the last inspection and the staff file of the most recent was checked. All the required checks had been undertaken including two written references, a Criminal Record Bureau (CRB) check and a comprehensive application form. However the results of checks by the POVA1st scheme, as part of the CRB check, were not present and this may lead to be inappropriate people being given access to vulnerable residents. Staff reported that they followed a satisfactory induction programme at the start of their employment. Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The service is well managed with resident’s and relative’s views considered, with the result that a homely, safe and open environment has been created. EVIDENCE: The registered manager, who has worked at the home for a number of years, had undertaken the required management qualifications. She is very experienced and dedicated to the job and is well supported by the staff group who spoke positively about her influence on the home. ‘Always very approachable’ ‘She encourages teamwork and for us to take responsibility’. The registered provider’s time and commitment to the home should also be commended; he demonstrated that he knew all staff and residents, and spoke with them most days. Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 19 A questionnaire had been circulated to all residents last year and an analysis of this had been undertaken and the results displayed. The questionnaire results were that residents were 100 satisfied with the staff, hygiene, personal care and laundry. One resident commented when asked about entertainment and outings that they wished their family take them out more. In response, the manager spoke with the family on the half of the resident about this issue. Another resident said that there was not sufficient choice around suppertime. In response to this additional snacks were now available. There is a regular meeting for residents and their relatives to raise issues with the home’s management and also an annual meeting for staff to highlight their priorities for new expenditures within the home in the following year. Similarly the manager and proprietor explicitly plan expenditure for the home’s environment but not for any other aspects of the home’s operation. Policies and procedures are regularly reviewed by the registered provider and are available for staff and residents to view. Although the minimum standard for one-to-one staff supervision is six times per year, the manager and staff have found that this was not necessary given the length of time most staff had worked at the home. The manager felt that supervision at this level was important for new staff, but long-standing experienced staff would be supervised less often and this has been incorporated in the home’s written policy concerning supervision of staff. From an audit of Health and Safety practice in the home, records indicated that all matters were satisfactory in this area. Of particular note is the standard of staff training which includes ‘top-up’ training in all the required subjects. Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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 OP9 Regulation 13(2) Requirement A written record of the temperature of medicines fridge and the calibration of its thermometer must be maintained. Written records of the completion of checks of all newly appointed staff under the POVA1st system, as part of the CRB checking process, must be maintained. Timescale for action 30/06/06 2. OP29 19 30/06/06 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 OP1 Good Practice Recommendations Consideration should be given to amending the outside sign that states that the home is registered with Derbyshire County Council. All risk assessments contained within care plans must be reviewed and amended, where required, on a regular DS0000020084.V296418.R01.S.doc Version 5.2 Page 22 2. OP3 Ridgewood House 3. 4. OP19 OP33 basis. The Fire Officer should be consulted about the need for a follow up inspection of fire safety practices at the home. An Annual Plan for of all aspects the home’s operation should be developed. Ridgewood House DS0000020084.V296418.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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