Inspection on 19/01/06 for Risby Park Nursing Home

This inspection was carried out on 19th January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Risby Park Nursing Home 07/09/07

Risby Park Nursing Home 19/09/06

Risby Park Nursing Home 07/11/05

Risby Park Nursing Home 21/10/04

Risby Park Nursing Home 14/07/04

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 Park Nursing Home Hall Lane Risby Bury St Edmunds Suffolk IP28 6RS Lead Inspector Cecilia McKillop Unannounced Inspection 19th January 2006 11:30 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 Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Risby Park Nursing Home Address Hall Lane Risby Bury St Edmunds Suffolk IP28 6RS 01284 811921 01284 811950 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) Risby Hall Nursing Home Limited Ms Alison Rachel Lovelock Care Home 54 Category(ies) of Old age, not falling within any other category registration, with number (54), Physical disability (12) of places Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th November 2005 Brief Description of the Service: Risby Park was first registered in 1997 and currently operates as a care home providing nursing care for 54 older people. The home is situated in Risby village West Suffolk and is adjacent to Risby Hall Nursing Home, which is also owned by the same proprietors, Risby Hall Nursing Homes Limited. The accommodation at Risby Park is on two floors and there is level access throughout the home with 2 shaft lifts connecting the ground and first floors. The facilities were purpose built and include 46 single ensuite rooms, 4 double ensuite rooms and a variety of day and quiet rooms. The home overlooks pleasant gardens and farmland. Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an unannounced inspection, which was carried out during the late morning and afternoon. The manager and the deputy manager were both on duty and assisted the inspector to assess records and other documentation. There were 49 service users residing at the home on the day of the inspection. Three service users were interviewed about their experience of the home. Discussions were held with three staff about their training and duties at the home. A tour of the accommodation was undertaken. Overall this was a positive inspection, and the atmosphere within the home was relaxed and the interactions observed between staff and service users were warm and friendly. What the service does well: What has improved since the last inspection? At the last inspection issues were raised about staffing levels at the home. The manager responded to the concerns, which were expressed by reviewing dependency levels and starting a forum for staff representatives to raises issues pertaining to their role. As a result of the meetings some changes were made to the routines within the home and the distribution of duties among staff. Since the last inspection the home had successfully filled a number of vacancies. The home was also operating with a number of service user vacancies. Staff levels were adequate on the day of the inspection. Service users who were interviewed reported that while staff were busy there were sufficient numbers of staff available. Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 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 Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 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 Service users can be assured that their needs will be assessed and considered as part of the admission process into the home. EVIDENCE: A member of the management team assesses service user’s needs prior to their admission. The records of a newly admitted service user were examined as part of the inspection and the assessment was comprehensive and well documented. The assessment information was used to form the basis of the service users initial care plan. Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 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 Service users personal, social and health care needs were clearly documented and there were clear procedures in place with regard to the administration of medication. EVIDENCE: A sample of care plans were examined as part of the inspection. These were found to be detailed, informative and outlined the actions required by staff to meet the service users needs. A number of the care plans had been signed by service users. There was evidence of ongoing monitoring around the health of the service users including nutritional screening and regular weighing. There were clear plans in place to prevent and manage pressure sores, which were subject to regular auditing. The care plans were regularly reviewed and there was evidence of the staff consulting and working with other health professionals such as dieticians, and psychologists. In one example it was positive to note that staff were encouraged to use photographs to assist with communication. Risk assessments were in place with regard to manual handling and other perceived risks. Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 Page 10 Care plans address the service users wishes in the event of their death. The home has recently started to display the times of the funeral services of service users who have died and this was welcomed by one service user as a positive development which would better enable service users to pay their respects. Service users spoke positively about the care that they receive from staff and staff were observed, speaking respectfully to service users and knocking on doors before entering. Chiropodists and Opticians visit the home regularly. Medication was being securely stored on the day of the inspection. A sample of the records were examined and these were in order and corresponded with the medication, which had been prescribed. The Deputy Manager confirmed that there are systems in place to oversee medication practices and address any shortfalls. The home are intending to make significant changes to their medication systems but the manager confirmed that additional training will be provided to staff before any of the new changes are implemented. This will be followed up at the next inspection. Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 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): 12,14 The home provides a good variety of social and recreational activities and service users are assisted to exercise choice and control over their lives. EVIDENCE: The home has 3 part time activity co-ordinators who provide a range of social and recreational activities throughout the week. The activity organisers had recently organised a meeting with other organisers to further develop knowledge and pool resources. There is daily activity programme, which was on display, and there was a good balance of home based activities and trips out on offer. One to one time is spent with service users who are frail and not able to attend group activities. There is an in-house shop were service users can purchase small items and service users are provided with a range of toiletries. The home has its own informative newsletter. Regular resident committee meetings are held, which are chaired by a service user and to which the manager of the home is invited. A committee meeting was being held on the day of the inspection. Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 Page 12 Bedrooms had all been personalised by service users and the home had accommodated service users requests for items such as fridges, computer and a pet bird. Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 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): 16 Complaints are taken seriously by the homes management and acted upon. EVIDENCE: Since the last inspection there had been one complaint, which was made direct to the home. This had been investigated and the home had responded directly to the complainant. Service users who were interviewed were clear about how to make a complaint. Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 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): 19,26 Service users at Risby Park live in a comfortable, clean and well maintained home. EVIDENCE: The home is accessible for wheelchair users with level access and automatic doors at the entrance. The home is organised over two floors and connected by a shaft lift. There are plans to improve accessibility into the garden. The accommodation is of a good standard and all rooms are en-suite. Service users had personalised their bedrooms with items of furnishings, pictures and mementoes The home was generally clean and smelt fresh. There was an average of four domestic staff rostered on duty. The home has its own laundry containing a number of commercial washers and dryers. Staff interviewed were clear about the importance of good infection control procedures. The sample of sheets and towels, which were examined, were in a good condition and there were sufficient numbers of replacements in the store. Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 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 The home is staffed by an adequate number of staff, who receive ongoing training. EVIDENCE: The manager informed the inspector that the home was fully staffed and they had successfully recruited staff to fill the vacancies identified at the last inspection. The home has started a staffing forum where staff and management representatives meet to discuss common issues. The manager reported that the initial meetings were positive and changes have been made to staff duties as a result. There have been no significant changes to the staffing levels within the home since the last inspection but a member of staff is now starting work at 7.30 am to assist with the breakfast preparation. Manual handling update training was underway on the day of the inspection and staff interviewed reported that there was good access to training. One newly appointed member of staff spoke positively about the quality of the induction and the support available to new staff. She confirmed that she had undertaken the Topps induction and foundation training and was planning to undertake NVQ training. The home employs 35 care staff, approximately equivalent to 22 full time staff. Nine care staff have achieved NVQ level 2 or above and three more staff are due to commence this qualification. The numbers of staff with this qualification Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 Page 16 are below the recommended levels and the manager said that this was due to the fact that a number of staff had left and there was a low take up among the existing staff team. Staff reported that the staffing levels were appropriate but there were sometimes shortfalls which was generally caused by staff going off sick just before of at the beginning of a shift. It was acknowledged that efforts were made by management to obtain additional staff. The levels of staffing on the day of the inspection were satisfactory and staff were observed responding quickly to resident’s call bells and going about their duties in a calm and unhurried manner. Service users who were interviewed were positive about the staff and said that they worked hard. One service user raised an issue about staff breaks and the manager agreed to remind staff of the importance of completing duties before going of on breaks. Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 Page 17 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): 31,33,35,38 The home is managed by an experienced manager who provides clear leadership and support to staff EVIDENCE: The manager is a qualified nurse who has significant management experience and the deputy manager who has worked at the home for several years assists her. There was also an assistant deputy in post. The staff and service users spoke positively about the management. Staff described the matron as supportive and service users reported that all the management team were sympathetic and approachable. The manager undertakes regular audits on a number of areas to insure that staff are working in a consistent way. Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 Page 18 Service users or their families control their own financial affairs and the home is not involved as an agent for any of the service users. There is also a quality assurance system in place, which involves questionnaires being sent to service users and their families asking for their views on the quality of the service. The questionnaires are sent out on a yearly basis and results are collated and published. The home formally responds to any issues, which are identified, and outlines any changes to be made as a consequence. The home has its own resident committee, which met on the day of the inspection .The committee is chaired by one of the service users and the minutes are put on display for other service users and relatives to read. The minutes indicate that the meetings are well attended, the discussions wide ranging and clear actions agreed. Staff confirmed that they receive regular training on a range of areas including manual handling, infection control and vulnerable adults. Accident reports were examined and there was evidence of management oversight. Risk assessments were in place and the sample, which were examined were satisfactory. Water temperatures were within recommended levels and there was evidence of ongoing monitoring of these and the fire preventions measures. The home’s health and safety policy was in the process of being updated and the manager outlines some changes to practices, which were being changed as a result. Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 Page 19 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 N/A N/A 3 N/A N/A N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 N/A 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 N/A 14 3 15 N/A COMPLAINTS AND PROTECTION Standard No Score 16 3 17 N/A 18 N/A 3 N/A N/A N/A N/A N/A N/A 3 STAFFING Standard No Score 27 3 28 2 29 N/A 30 N/A MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 N/A 3 N/A 3 N/A N/A 3 Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 Page 20 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. 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 OP28 Good Practice Recommendations It is recommended that the home develop a long-term strategy to ensure that they have 50 of care staff qualified to NVQ level 2. Risby Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Suffolk Area Office St Vincent House 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 Park Nursing Home DS0000024481.V280041.R01.S.doc Version 5.1 Page 22 - 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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