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Inspection on 17/11/05 for Ridgway House

Also see our care home review for Ridgway House for more information

This inspection was carried out on 17th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The Home has a committed staff group. Residents spoken to felt that their relationships with staff were very good and that staff provided them with good care and support and valued and respected as individuals. Routines are relaxed and flexible and Residents confirmed that they are enabled to continue the routines they have followed through their lives and maintain their independence as much as is possible. Staff ensure that Residents Health Care needs are closely monitored with prompt referral made to Medical Professionals where necessary. Residents with dementia care needs are well supported. Meals are varied, well balanced, of good quality and nicely presented. Residents stated that they are given a good choice of options in the daily menu and account is taken of their likes and dislikes and special diets.

What has improved since the last inspection?

The Home has developed dedicated units for Residents with dementia with consistent staff deployed to provide continuity of care. Attention has been paid to the development of Life Histories for all Residents but particularly those with Dementia. The information enables staff to have a better understanding of the individual`s needs, informs then of things that are important to the Individuals and in the case of Residents with Dementia promotes more effective understanding, communication and interaction between Residents and staff. Residents with Dementia are supported in managing their frustrations and anxieties. Strategies for the management of behaviours have been devised and staff skilfully handle difficult situations and ensure that Residents are sensitively assisted when upset and frustrated. Care plans have been revised and showed a holistic approach with an increased level of instruction and guidance for staff on how to support Residents.

What the care home could do better:

Ensure that the timings for care routines are clearly documented on the care plans alongside written strategies for the management of behaviours where necessary.

CARE HOMES FOR OLDER PEOPLE Ridgway House 1 Swinneyford Road Towcester Northants NN12 6HD Lead Inspector Mrs Pat Harte Unannounced Inspection 17th November 2005 12:00 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 Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 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. Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ridgway House Address 1 Swinneyford Road Towcester Northants NN12 6HD 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) 01327 350700 01327 352369 www.northamptonshire.gov.uk Northamptonshire County Council Mrs Sarah Jane Holland Care Home 35 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (35), of places Physical disability over 65 years of age (4) Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. 9. Within the Permanent Unit No person falling within category OP can be admitted into the unit where there are 31 persons of category OP already in the unit. Within the Permanent Unit No person falling within category DE(E) can be admitted into the unit where there are 10 persons of category DE(E) already in the unit. Within the Permanent Unit No person falling within category PD(E) can be admitted into the unit where there are 3 persons of category PD(E) already in the unit. Within the Permanent Unit Total number of service users in this unit must not exceed 31. Within the Short Term Unit No person falling within category OP can be admitted into the unit where there are 4 persons of category OP already in the unit. Within the Short Term Unit No person falling within category DE(E) can be admitted into the unit where there is 1 person of category DE(E) already in the unit. Within the Short Term Unit No person falling within category PD(E) can be admitted into the unit where there is 1 person of category PD(E) already in the unit. Within the Short Term Unit Total number of service users in this unit must not exceed 4. Total number of Service Users in the home must not exceed 35. Date of last inspection 19/05/05 Brief Description of the Service: Ridgeway House is a residential care home owned by Northamptonshire County Council and Managed by Mrs. S. Holland and Mrs. C. Bell. The Home provides personal care for up to 35 permanent Elderly Residents. The Home can provide care for up 4 Residents with Physical Disabilities and 10 Residents with Dementia. The Home is situated close to the town centre of Towcester and its local amenities and facilities. The premises consist of two-storey building with a passenger lift provided. All Residents are provided with single bedrooms. Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 5 There are 5 units each with lounge / dining areas and kitchenettes. One of the units is dedicated to providing care for Residents with Dementia. There is also a central kitchen providing main meals to Residents. The home has laundry facilities. The Home has a Bar and a separate designated smoking area for Residents. Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for Service Users and their views of the service provided. Inspection planning took one hour and consisted of a review of the last inspection report and requirements, the Home’s service history including notifications and events. The primary method of inspection used was ‘case tracking’ which involved selecting three Residents and tracking the care they receive through review of their records, talking with them and the care staff. In addition five staff and six Residents were spoken with to gain their opinions on the service. A partial tour of the premises took place, a selection of records was inspected and observations made on care practices. Discussions were held with the Registered Manager. The Inspection took place from mid day and the afternoon over a period of four hours and was carried out on an unannounced basis What the service does well: The Home has a committed staff group. Residents spoken to felt that their relationships with staff were very good and that staff provided them with good care and support and valued and respected as individuals. Routines are relaxed and flexible and Residents confirmed that they are enabled to continue the routines they have followed through their lives and maintain their independence as much as is possible. Staff ensure that Residents Health Care needs are closely monitored with prompt referral made to Medical Professionals where necessary. Residents with dementia care needs are well supported. Meals are varied, well balanced, of good quality and nicely presented. Residents stated that they are given a good choice of options in the daily menu and account is taken of their likes and dislikes and special diets. Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 7 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. Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 8 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 Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 9 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): 1, 2, 3, 4 & 5 Prospective Residents are provided with information to enable them to make informed choice regarding their placement. The pre-admission assessment is thorough and effective in ensuring that the needs of people admitted to the home can be met. EVIDENCE: The admission process ensures that all prospective Residents are visited and assessed by staff from the Home to ensure their needs can be met. Residents and their relatives have opportunities to visit the Home and are given information on the services and facilities. Residents spoken with felt that staff were well briefed on their needs and the care to be provided. Staff spoken with felt that they were provided with good information on their Residents needs, routines and wishes. Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 10 A newer Resident stated that staff had been very kind and understanding and had provided her with good support, which enabled her to settle quickly into her new home. Individual records are kept for each of the Residents and inspection of the records showed that the assessment process was thorough, specific assessment tools were used to identify needs and risk and assessments were carefully documented. Contracts are provided to all Residents with copies maintained on individual Residents files. Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 11 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, 9 & 10 Care plans clearly documented Residents needs and provided a good level of instruction and guidance for staff on how the care was to be carried through including guidance on how Resident’s with Dementia are to be supported. EVIDENCE: Care plan formats have been reviewed and all existing care plans have been updated to the new format. Three Residents care plans were inspected. The plans showed a holistic approach and detailed guidance and instruction for staff on how the care was to be provided though the timings for some routines were not detailed in all instances. Attention has been paid to ensuring that information is gathered on Residents’ Life Histories with specific attention given to the histories of Residents with Dementia. Staff commented that the information gave them a better understanding of needs and enabled them to communicate more effectively with their Residents. Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 12 Discussions with staff showed that they knew their Residents well. Strategies for the management of behaviours for Dementia care Residents were in place and were known to staff though these were not always written into the care plans. The care plans showed that account is taken of Residents wishes in relation to their preferred routines and how the care is to be provided. Plans detailed tasks that Residents’ could undertake for themselves showing that they were encouraged to maintain their independence as much as possible. Residents also stated that they felt respected and valued as individuals and encouraged to take control of their lives. Health care needs were clearly documented. Residents commented and records showed that staff responded quickly to any changes and made referrals to the appropriate Medical Professionals. Residents were enabled to see their General Practitioners quickly. Care plans gave clear instructions on how staff were to monitor health needs. The care plans did not always reflect the emotional support provided to Residents although it was clear from discussions with Residents that staff noted their moods and events that had affected them and were quick to respond and provide support. Procedures were in place for the management of Medication. Storage of medication was appropriate and safe. The mid day medication round was carried through safely and efficiently. Observations confirmed that Staff ensure the protection of Residents privacy and dignity when carrying through personal care. Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 13 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 & 15 Residents are enabled to maintain their independence as much as possible and exercise control and choice in the way they wish to lead their lives. The meals in the Home are good, offering choice and variety and catering for special dietary needs and individual likes and dislikes. EVIDENCE: Residents felt routines were relaxed and flexible and that their preferences on rising and going to bed times were respected. They felt that they were free to decide on how and where they wished to spend their time and that they were encouraged to maintain their independence. The Home has an open visiting policy and Residents confirmed that they were enabled to receive their visitors in private if they wished. The Home has a good approach to providing activities on either a group or individual basis. Residents confirmed that staff found time to sit and talk with them. Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 14 Consistent staff are deployed to the units dedicated for the care of Residents with Dementia to provide continuity. It was clear that staff interacted well with their Residents and provided them with a range of meaningful and suitable activities. Residents were pleased to show their artwork displayed in one lounge. A number of Residents were spoken to and everyone who commented on the food said it was good, that they had choice and their special and likes and dislikes were catered for and respected. Residents are asked to comment and offer suggestions on the menu and changes are made accordingly. The midday meal was efficiently served and nicely presented. Staff helped Residents with their meals where necessary. Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 15 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): 16 & 18 Systems are in place to protect Residents from abuse and to ensure that complaints are listened to and acted upon. EVIDENCE: Residents confirmed that they had been given the Home’s complaints procedure which is also displayed in the Home. Residents and visiting Relatives spoken with felt confident and able to raise any issues or concerns with staff. A complaints record is maintained. No complaints have been received by the CSCI. Robust procedures for the Protection of Vulnerable Adults are in place. Staff demonstrated, through discussions, their full understanding of the reporting procedures. Records and notifications received by the Commission confirm that any allegations are reported. Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 16 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, 20, 21, 22, 23, 24, 25 & 26 Residents are provided with a well-maintained, safe, comfortable and homely environment. EVIDENCE: The premises were in good order, clean, warm, comfortable and well maintained. Since the last Inspection considerable refurbishment and maintenance work has been carried out to improve the appearance of the Home and address safety issues. A new kitchenette has been fitted in one unit, the electrical wiring ha been replaced in Althorpe unit and the front hall. Decoration work has been carried out to the corridor areas. Exit doors have been secured so that Residents with Dementia cannot leave the building unnoticed and an extractor fan has been fitted in the Residents’ smoking area to reduce the effects of the smoke. Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 17 The garden provision is currently being reviewed and it is anticipated that attention will be paid to creating secure garden areas for Residents with Dementia. Standards of domestic and hygiene maintenance were viewed as very good throughout the areas of the premises viewed. Residents stated that cleaning routines were carefully organised to ensure no disruption to their routines. Residents are enabled to personalise their rooms as they wish and have their furnishings and belongings around them. Due attention was paid to ensuring a safe environment. Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 18 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 Sufficient numbers of care staff are deployed to meet the needs of current Residents. EVIDENCE: Residents spoken with said that the staff were very kind, committed and caring. Relationships between staff and Residents were good. On the early shifts there are 6 Carers, one deployed to each of the 5 units with responsibility for monitoring and supervision and 1 carer floating to provide additional support where two carers are necessary. In the evenings the number of cares is reduced to 4 but 1 carer is deployed to cover the dedicated Dementia care unit. 3 carers provide night care. In addition at least one Residential Care Supervisor is on duty from 7.30 am to 10.00pm to supervise and lead the shift. Ancillary staff include Catering, Domestic staff and a Handyman ensuring that care staff are free to care for their Residents. Discussions with the Manager, staff and Residents confirmed that the staffing numbers were sufficient for the current needs of the Residents, staffing can be adjusted where necessary. Staff were observed to respond quickly to call bells and Residents requests for assistance. Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 19 Discussions with staff confirmed that they are provided with core training and regular updates. Specialist dementia care training has also been provided and staff are encouraged to undertake a National Vocational Qualification. Staff spoken with showed a commitment to the well being of their Residents and knowledge of the Home’s aims and objectives and policies and procedures. Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 20 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, 32, 33 & 38 The Management of the Home is effective and the home is run in the best interests of the Residents. The systems for the management of Residents monies and items held for safekeeping are safely maintained. EVIDENCE: The Home has two Managers working on a job share basis. Currently Mrs. Bell is undertaking a secondment outside of the Home and Mrs. Holland has assumed full time responsibility for the running of the Home. Staff spoken with felt that the Managers were easily accessible to them and was willing to discuss any issues, guide them in practice and offer support. They confirmed that systems for informal as well as formal supervision were in place. Residents felt the Managers were readily available to them. They commented that regular Residents meetings were held and that the Managers consulted Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 21 with them and sought their individual views and opinions. Residents felt that they had trust and confidence in both the Managers and the staff group as a whole, relationships were observed to be very good. Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 22 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 3 3 3 3 3 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 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X X 3 Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 23 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. 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 Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ridgway House DS0000034911.V265498.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!