Inspection on 05/05/05 for Risby Hall Nursing Home

This inspection was carried out on 5th May 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.

Other inspections for this house

Risby Hall Nursing Home 29/08/07

Risby Hall Nursing Home 07/09/06

Risby Hall Nursing Home 03/10/05

Risby Hall Nursing Home 01/02/05

Risby Hall Nursing Home 06/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Risby Hall Nursing Home Hall Lane Risby Bury St Edmunds Suffolk, IP28 6RS Lead Inspector Cecilia McKillop Unannounced 5th May 2005 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 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. Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Risby Hall Nursing Home Address Hall Lane, Risby, Bury St Edmunds, Suffolk, IP28 6RS Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01284 810921 01284 810754 None Risby Hall Nursing Home Limited Ms Alison Lovelock CRH 36 Category(ies) of Old age, not falling within any other category registration, with number (36), Physical disability (4) of places Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 01/02/05 Brief Description of the Service: Risby Hall is a care home for older people providing nursing care for 36 service users. The home has been established for many years under the proprietorship of Risby Hall Nursing Homes limited. The registered proprietors are actively involved in the management of the home. Risby Hall is situated on the edge of Risby village west Suffolk and was built from what were originally the farmhouse and outbuildings. The accommodation is all on the ground floor with level access throughout. The facilities are homely and comfortable and there are 20 single bedrooms and 8 shared rooms. Risby Park, which is also a care home for older people, is located adjacent to Risby Hall. Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows a routine unannounced inspection of Risby Hall. The inspection took place over 6 hours during the morning and afternoon. The inspector interviewed the manager one member of nursing staff and two care staff. Discussions about the care provided at the home were held with 6 service users and with a relative who was visiting the home. A tour of the accommodation was made and a small number of records were examined. What the service does well: What has improved since the last inspection? What they could do better: Access to the home could be further improved by the levelling of the concrete outside the entrance doors. Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 Page 6 Both service users and staff who were interviewed reported that there were sometimes staffing shortage and this appeared to be caused by staff ringing in sick at the last moment. The inspector was however assured that the homes management were addressing this with the staff concerned. Progress in this area will be followed up at the next inspection. 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. Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 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 standard(s) 3 Service users needs are assessed before their admission and they can have some confidence that as a result of being identified, their needs can be met. EVIDENCE: The records on a newly admitted service user were examined as part of the inspection and there was evidence that an assessment of their care/nursing needs had been undertaken before they were admitted to the home. A care plan had been formulated from the assessment and there was evidence that the family and service user had been involved in the process. Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 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 standard(s) 7,8,10 Service users will have a clear plan, which outlines and monitors there changing needs. They will have good access to health care and can be assured that they will be treated with respect. EVIDENCE: The care plans for 3 service users were examined and these were informative about service users needs and they detailed how care was being provided and monitored. They are complimented by plans in service user bedrooms, which provide practical details, and service users preferences for care delivery. There was evidence that accidents were being noted and that risk assessments were being reviewed. A number of service users were using air mattresses and there were plans in place to monitor and treat pressure areas. There were auditing arrangements in place to look at incidence of pressure sores, how they arose, the treatments and changes. There was evidence of ongoing consultation with other professionals such as GP’s and chiropodists. Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 Page 10 The service users who were interviewed spoke positively about the care that they received from staff. The inspector observed service users being offered choices, using the screens in the double rooms and knocking on doors before entering. Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 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 standard(s) 12,13 15 Service users are helped to exercises choices and controls over their lives and to maintain contacts with friends and family. The meals provided are well presented. EVIDENCE: Service users interests are outlined as part of the assessment and planning process. There is an activities organiser who organises different activities in and outside the home. The inspector was informed that there had been a recent boat trip organised but there are also in-house activities such as cooking. The activity organiser is also able to spend time with people on an individual basis such as letter reading. On the display board there was a request for recipes, which were being collected for an in house cookery book, which was being developed. On the day of the unannounced inspection service users had a choice of steak and kidney pie or chicken casserole for their lunchtime meal. Service users who were spoken with were positive about the quality of the meal provided and the choices that were available. One service user said that she only liked fish and that this was always accommodated. Staff were observed helping service users who needed assistance in a sensitive and unrushed manner. Those service users who were in bed were made comfortable before staff started to assist them eat. The inspector was informed that care staff had Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 Page 12 recently had training on good practice when feeding service users. The meal was kept warm in a heated trolley before being served. Fresh fruit was available for service users. Some relatives visit the home on a daily basis to help their relative and service users reported that they were able to maintain contacts with friends and family. Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 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 standard(s) 16,18 The home takes a number of steps to protect service users from abuse and to address any concerns that arise. EVIDENCE: The home has clear procedures around vulnerable adults and staff who were spoken to as part of the inspection confirmed that they had received training on how to respond to an allegation of abuse or if they noted something inappropriate. Care staff reported that there was an team approach and they would be able to raise issues directly with the manager. The service users who were interviewed were clear as to what they would do if they had a concern about their care and expressed some confidence that matters would be addressed. The home has sound procedures for the recruitment of staff, which involves referencing, CRB checks and Pova first checks. Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 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 standard(s) 19,24 Service users live in clean and comfortable home. The planned refurbishments will enhance the independence of service users. EVIDENCE: Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 Page 15 The accommodation was found to be comfortable, clean and generally well maintained. The home is all one level and is generally accessible. There is a small step however at the front door and staff cover this with mobile cover when service users who are wheelchair dependant request to go out. The paving/concrete outside is somewhat uneven and it was agreed that service users independence and comfort would be enhanced if this area was improved. The proprietor confirmed that this was an area where developments are planned. There was a range of specialist equipment available to assist service users. The arrangement in place for the servicing of the hoists was examined and there was evidence that this was undertaken on a regular basis. The radiators have all now been fitted with covers which provides protection to service users. There has been some refurbishment of the bathrooms and they now look much more inviting. Some of the flooring in the toilets was stained and the inspector was informed that this was due to water damage. The wall paper in one of the toilets was also showing signs of wear and tear and the inspector was informed that these areas were due to be refurbished. The bedrooms were all very comfortable and a number had been highly personalised by the service user who had brought in a lot of their possessions. However a number of the single rooms are small as the home was in operation before the national minimum standards came into place. There were twenty single rooms and eight shared rooms, therefore a relatively high proportion of service users share. Where service users share there is screening provided to ensure privacy. Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 Service users are protected by the homes recruitment polices and receive care from sufficient numbers of trained staff. EVIDENCE: Since the last inspection the homes management were required to review dependency levels and staffing and this has been undertaken. The homes management concluded that the staffing levels were satisfactory and that no changes were needed. On the day of the inspection there were 6 carers and two trained members of nursing staff on duty in the morning. In the afternoon there were 3 carers and three nursing staff. On the evening shift there were 3 carers and 2 trained nurses. The staff who were spoken with as part of the inspection reported that staff were sometimes stretched as a number of the service users were quite frail. They and service users referred to the home being short staffed on occasions, although they were able to use staff from the adjoining home . The shortfalls were generally due to staff going off sick at short notice. The homes management informed the inspector that they were aware of the problem and were taking action to address it. This will be followed up at a future inspection. Staff reported good access to induction and foundation training. Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 Page 17 The recruitment records of two members of staff were examined at the inspection and there was evidence sound recruitment practices with CRB checks, references, and interview details. Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34,35,37,38 There are sound procedures and administrative systems to protect and safeguard service users. EVIDENCE: The manager who has applied to the Commission for registration has sound systems in place to monitor and audit the homes performance in a number of areas. There was evidence that where shortfalls arise these were being picked up and addressed through staff supervision. Service users and their families are assisted to retain responsibility of their finances where possible. Hairdressing and other items, which are purchased, are all billed. The proprietor acts as an agent for one service user, which is a long-standing arrangement, and there were clear accounts in place documenting all transactions. Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 Page 19 All staff receive training on a wide range of areas including moving and handling and first aid. Testing of water temperatures in the bathrooms is undertaken regularly and on the day of the inspection the water temperatures were within the recommended levels. Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x 3 x x STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x x 3 3 x 3 3 Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 Page 21 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 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 19 Good Practice Recommendations It is recommended that the home improve the access into the building . Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 5th Floor, St Vincent House 1 Cutler Street Ipswich Suffolk, IP1 1UQ 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 Risby Hall Nursing Home I54-I04 S24481 Risby Park V230288 050505 Stage 4.doc Version 1.30 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. 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. 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