Inspection on 30/10/05 for Ridgwell House

This inspection was carried out on 30th October 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ridgwell House 14/04/09

Ridgwell House 07/05/08

Ridgwell House 26/04/07

Ridgwell House 27/09/06

Ridgwell House 17/02/06

Ridgwell House 04/02/05

Ridgwell House 08/09/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Ridgwell House 95 Dulwich Road Holland on Sea Essex CO15 5LZ Lead Inspector Sara Naylor-Wild Unannounced Inspection 30th October 2005 12:30 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 Ridgwell House DS0000060997.V257094.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. Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ridgwell House Address 95 Dulwich Road Holland on Sea Essex CO15 5LZ 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) 01255 815633 01255 815633 Prestige International (EC) Ltd Care Home 16 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (16) of places Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons of either sex, aged 65 years and over, falling only within the category of Old Age (not exceeding 16 persons) Four persons, over the age of 65 years, falling only within the category of Dementia, whose names were made known to the Commission in February 2003 The total number of service users accommodated in the home must not exceed 16 persons The registered manager, in association with the Responsible Individual, devises and attains a programme of development, at the end of which she is able to demontrate her full awareness of the responsibilities of the role. Specifically this should include awareness of how staffing is calculated, POVA procedures, health and safety legislation and development of policies and procedures. This should be concluded by 1st June 2005 4th February 2005 Date of last inspection Brief Description of the Service: Ridgwell House is an established care home for older people in the village of Holland on Sea, near the town of Clacton on Sea. The home has been open since 1985, and was registered to the present owners Prestige International (EC) Ltd in July 2004. The accommodation offers care for 16 service users on the ground and first floors. At the time of the inspection a double bedroom was used to accommodate a single person and therefore all accommodation is in single rooms for 15 service users. There is a stair lift to the first floor. The majority of the accommodation is on the ground floor, with 4 service users on the first floor. There are 3 bathrooms and 1 shower room, all with toilets. In addition, there are 3 separate toilets around the home. Catering and laundering facilities are found in the centre of the home. Communal areas consist of a front and rear lounge and a large dining room. The rear lounge overlooks the rear garden, which is laid to lawn with flowers, shrubs, fruit trees and vegetable beds. In the garden there is a summerhouse, a green house and shed. Seating is provided during the summer in the garden. The front garden has a semi-circular driveway offering some off-road parking. Flowerbeds, plant pots, flowering shrubs and trees bring colour and interest to this area. Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on Sunday 30th October 2005. The appointed manager was not on duty and the inspector was assisted in the course of the visit by the staff in charge of the shift. Since the previous visit there had been a change of manager, and the newly appointed post holder Ms Chalk, was undergoing the process for registration with the Commission. There had not been any significant reduction in the number of requirements and recommendations made in the last report, however there is an acknowledged progress made in addressing them. What the service does well: What has improved since the last inspection? The new manager had already had an impact on the operations of the home at the time of the inspection. This included a general sense of renewed purpose in the staff group and initiatives such as activities and care planning being addressed to meet the expectation of the National Minimum Standards(NMS). The reports from service users and staff were all positive in relation to the manager’s approach and her focus on the home. Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 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. Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 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 Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 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. Assessments of needs require development to ensure they cover all aspects of individuals’ issues affecting care. The home does not provide intermediate care. EVIDENCE: The files of existing service users did not contain in-depth assessments of both needs and abilities. The documentation requires development to ensure it provides sufficient information to both form a picture of how the home could support the service user and whether this level of support is appropriate to the service. Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 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, 9 and 10. Care planning documentation requires further work. Medication follows appropriate procedures and guidelines. The service users are supported in a manner that upholds their rights. EVIDENCE: Care plans of three service users seen during the inspection indicated that further work is required to ensure there are consistent levels of information held in regard to the support the service user requires in their everyday activities. A person centred programme that clearly sets out how staff are to action the support is essential. Daily records contained some good detailed observations made by staff in relation to the individual service users movements that day and how they had coped. Service users’ health care was monitored in daily records such as GP and nurses visits. Not all care plans contained monitoring records of such visits or Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 Page 10 their outcomes. Further work is required to ensure that this information is held appropriately and any changes to service users’ care plans initiated. Medication systems had been changed to a monitored dosage system, which was now stored in a lockable metal cupboard. The records relating to administration and receipt were appropriately kept. Service users spoken with were confident that the staff were respectful and treated them in a dignified manner. They said staff always knocked on doors and knew them well enough to address them by their first names. They felt that there was nothing that was too much trouble for the staff to do. Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 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. Activities are being developed to a greater extent than previously experienced in the home. Service users receive family and friends as they wish. The home provides choice and freedom where appropriate. The service users enjoy a menu of varied and appealing meals, which they enjoy. EVIDENCE: The service users spoken with during the inspection outlined how they felt the available activities on offer in the home had increased. They were keen to mention the evening meal outing planned for the next month, and initiatives to introduce more activities in the day that were posted up on the dining room door. Staff informed the inspector of the appointment of an activities coordinator post which they hoped would assist them in providing activities to service users. They felt this was a good use of hours, as it would relieve them of the organisational aspects of activities whilst allowing them to participate in this aspect of care provision. Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 Page 12 Service users were clear that they were able to receive any visitors whenever they wanted. They said that the staff were hospitable and welcoming when visitors came. The service users spoken with during the inspection gave examples of where they are able to exercise choice in regard to going out, joining activities both in and outside the home, and daily choice of getting up and going to bed. It is observed that some of these choices are only exercised by the more able service uses and the home needs to establish how it supports choice amongst more dependent service users. Meals are provided against a planned menu with choices at both lunch and tea. Service users felt the menu provided a good variety of meals and these were cooked and presented in an appetising way. They were very clear that staff would supply them with alternatives at short notice if they did not like the meal served. The home maintains a record of the meals service users consume. Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 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): These standards were not addressed at this visit. EVIDENCE: Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 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. This standard was not fully assessed although a tour of the building included in the inspection visit did not identify any serious concerns regarding the premises. EVIDENCE: The home appeared well maintained and appropritate to the needs of service users. Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 Page 15 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 and 30. Staffing was maintained at sufficient levels to meet current service users’ needs. The staff group working at the home are stable and experienced. The staff training programme was underway and staff were aware of training opportunities. EVIDENCE: On the day of inspection the staffing on duty consisted of three care staff one of whom was in charge and the cook. The rota showed additionally that the home employed domestic staff in the mornings. The staff numbers appeared to provide staff with sufficent time to meet the needs of service users in an unhurried and calm manner. Staff felt that the additional hours proposed for the activities post would further benefit their involvement with service users. The staff group is in general a well established and stable group who are able to demonstrate through their practice an intuitive understanding of invidual needs. This factor has sustained the continuity of care within the home in the absence of appropriate professional records such as care plans. Staff were aware of the schedule of training programmed and discussed their attendance at sessions. The programme was unavailable for inspection at this visit and will be included at subsequent visits. Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 Page 16 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 and 32. The service users and staff were confident in the appointed manager’s abilities. The home is beginning to benefit from a defined sense of leadership. EVIDENCE: The discussions with service users and staff indicated that the recently appointed manager was having a positive impact on the home. Service users were impressed by the efforts she was making to understand their individual priorities in daily living and sought to address these where possible. They gave the increased focus on activities both inside and outside the home as an example. Staff spoke of a more definite leadership style where they felt they understood where the home was going and what was expected of them. They said that Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 Page 17 whilst they had liked the previous manager, they felt that her inexperience meant they led by committee and this had not helped the home move forward. At the time of the inspection the appointed manager was not yet registered by the Commission, this took place shortly after the visit. Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 Page 18 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X X STAFFING Standard No Score 27 3 28 3 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X X X X Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? YES 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 OP2 Regulation 5 Requirement The Registered Person must ensure that each service user is issued with a contract/statement of terms and conditions at the point of moving into the home. This standard was not assessed at this inspection and is therefore carried over to the next visit. 2 OP37 17 Schedule 3&4 The Registered Person must ensure that records required by regulation for the protection of service users and the effective and efficient running of the business are maintained, up to date and accurate. This standard was not assessed at this inspection and is therefore carried over to the next visit. 3 OP7 15 The registered person must ensure that a service user plan of care generated from a comprehensive assessment is drawn up with each service user to provide the basis for the care to be delivered. DS0000060997.V257094.R01.S.doc Timescale for action 31/03/06 31/03/06 31/03/06 Ridgwell House Version 5.0 Page 20 This is a repeat requirement. 4 OP3 14 The registered person must ensure that a comprehensive assessment is carried out for each service user using an appropriate holistic assessment tool. This is a repeat requirement. 5 OP8 13(4) The registered person must ensure that risks to the welfare of each service user are assessed and steps taken to minimise these. This is a repeat requirement. 6 OP29 19, Schedule 2 31/03/06 The registered person must ensure that staff files contain the documentation required by Regulation 19, Schedule 2, which protects service users. This standard was not assessed at this inspection and is therefore carried over to the next visit. 7 OP30 18 The registered person must ensure that the training provided for staff meets the expectations of the TOPPS standards. This standard was not fully assessed at this inspection and is therefore carried over to the next visit. 8 OP36 18 The registered person must ensure that staff supervision is consistently carried out. This standard was not assessed at this inspection and is therefore carried over to the next visit. 31/03/06 31/03/06 31/03/06 31/03/06 Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 Page 21 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 OP11 Good Practice Recommendations The registered person should ensure that individuals wishes concerning their spiritual needs, rights and function in relation to death and dying are recorded and observed through care planning. This standard was not assessed at this inspection and is therefore carried over to the next visit The registered person must ensure that service users’ choices and preferences in relation to daily living, activity, social emotional and spiritual needs are recorded and opportunities to exercise these are further developed. The registered person must ensure that the staffing numbers and mix of skills are sufficient to meet the assessed needs of service users and demonstrate this through the recommended calculation tool. The registered person should progress their plans to ensure that a minimum of 50 of staff are trained to NVQ 2 or equivalent by 2005. This standard was not assessed at this inspection and is therefore carried over to the next visit 2 OP12OP14 3 OP27 4 OP28 Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Ridgwell House DS0000060997.V257094.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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