Inspection on 12/09/05 for Risedale At Aldingham Nursing Home

This inspection was carried out on 12th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Risedale At Aldingham Nursing... 24/04/07

Risedale At Aldingham Nursing... 06/01/06

Risedale At Aldingham Nursing... 11/11/04

Risedale At Aldingham Nursing... 12/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

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

CARE HOMES FOR OLDER PEOPLE Risedale at Aldingham Nursing Home Aldingham Ulverston Cumbria LA12 9RT Lead Inspector Jenny Donnelly Unannounced 12 September 2005 09:20 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. Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Risedale at Aldingham Nursing Home Address Aldingham Ulverston Cumbria LA12 9RT 01229 869203 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) Risedale Estates Limited Graeme Redshaw Care Home 40 Category(ies) of DE(E) Dementia over 65 (10) registration, with number of places OP Old Age (40) Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1) The home is registered for a maximum of 40 service users to include: up to 40 service users in the category of OP (Older People) up to 10 service users in the category of DE(E) (Dementia over 65 years of age) 2) Dementia care is only to be provided to service users receiving personal care, not to those receiving nursing care 3) To include one named person under the age of 65 years (as notified by letter) 4) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 11/11/04 Brief Description of the Service: Risedale at Aldingham Nursing Home is set in the small hamlet of Aldingham, just off the coast road between Ulverston and Barrow-in-Furness, overlooking the Morecambe Bay estuary. The home is an imposing grade II listed building with many original features and is set in its own grounds. The home is one of five in Cumbria run by the Risedale Estates Limited Group. The registered manager is Mr Graeme Redshaw. Accomodation is provided over three floors, the ground floor plus a split level first floor, served by two passenger lifts. The bedrooms are individual in size and shape; there are 20 single and 10 double rooms, which the company refer to as companion rooms. All bedrooms have an en-suite toilet and wash hand basin. There are five bathrooms equipped with specialist bathing/showering facilities. There is plenty of communal space in the form of lounges, dining areas and a conservatory. The main kitchen and laundry are shared with the sister home St Cuthberts; which is an adjoined building run as a separate entity. The home has large lanscaped gardens and sea views. Although the home is registered to include 10 personal care places, the company is gradually changing these over to nursing beds as they become vacant. Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 12th September 2005 from 09.20 to 14.45 hours. Time was spent talking with residents, visitors, staff, the registered manager and Risedales’ director of nursing. A walking tour of the home was undertaken and care and medication records were viewed. There were 40 residents; 36 receiving nursing care and 4 receiving personal care only. What the service does well: What has improved since the last inspection? There were no requirements or recommendations made following the last inspection. The home had continued with planned improvements to the environment, and since the last inspection has provided new flooring and decoration throughout the lounges/dining areas. Several windows, two fire doors, and some older bedroom furniture had been replaced. The opening up of the previously divided lounge area has created more space for residents and enabled staff to observe frail residents more easily. The company had introduced a “skills register” detailing all of their employees with specialists skills and qualifications, so they can be easily contacted for advice by all of the Risedale homes. The Risedale wound care nurse specialist has been given additional time to spend visiting residents in each home as necessary to advise on wound care. Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 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. Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 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 Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 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) 1, 3, 4, 5 The homes’ admission procedures made sure that residents and their relatives were well informed about the home, and had the chance to visit and look around. Residents’ needs had been fully assessed prior to admission so the resident knew the home would be able to care for them appropriately. EVIDENCE: Residents and visitors said they had been able to visit Risedale at Aldingham, to have a look around, and meet with the manager and staff, before choosing to move in. Some residents said they were too ill at the time to make a visit, and so had relied on relatives to make the choice for them. All of these people said they were very happy with the choice of care home. Records showed that detailed assessments had been carried out for all new residents prior to admission. Each resident (or a relative) had been given a copy of this assessment along with a letter from the manager confirming Aldingham could meet his or her care needs. The four people in receipt of personal care only said they were disappointed that more nursing care clients had moved into the home, but as they liked Aldingham so much they preferred to stay, although an alternative had been offered. Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 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, 9, 10 The health and personal care needs of residents had been clearly recorded and showed people were receiving good general and specialised health care. The management of medicines in the home was also good and residents’ general wellbeing benefited from this. EVIDENCE: Care plans showed up to date information on all personal and health care needs. There were clear instructions for staff on who required what level of input and when. Residents said they had been consulted over changes in their plan of care, such as the introduction of using a hoist or any other type of equipment. The home kept good health records, which showed that residents had seen their doctor, dentist, chiropodist and optician, as well as any other specialist such as the wound care nurse. Safety instructions such as the use of hoists, bed rails and other specialist equipment were clearly recorded. Health needs, such as records of wound care, dressings, catheter or feed tube care were detailed and up to date to ensure staff gave consistent and correct care at all times. The medicine storage and records were inspected, and found to be in very good order. In line with new national rules, the home had introduced new procedures to ensure that waste medicines were properly disposed of. Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 Page 10 Residents said they felt very well cared for in this home and that nothing seemed too much trouble for the staff. Residents said they were treated with dignity and respect, saying “the staff and manager are wonderful”, “they’re excellent”. Staff were seen and heard talking to residents in a polite and friendly manner, and this was said by visitors to be the norm. Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 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, 14, 15 The home provided a good range of activities and social stimulation, and residents could choose whether or not to partake in these. Daily routines were based on the choices and needs of individual residents. The provision of meals was very good, offering both variety and choice, whilst catering for special dietary needs. EVIDENCE: The home employed a full time activities person who was qualified in aromatherapy and Indian head massage. Residents said they enjoyed spending time with him, either in groups for games and crafts, or on their own for a massage or nail care session. Some residents said they had enjoyed a boat trip on lake Windermere last week. Residents had also enjoyed visiting entertainers such as singers and musicians. While many residents spent their day in the lounge areas, some preferred to stay in their bedrooms. Some residents were clear that they did not wish to participate in activities, saying that getting up, bathed and dressed was enough activity given their state of health. Staff were seen to be walking with the fitter residents around the grounds and engaging in conversations with people in a natural way. Visitors confirmed that staff were always around, chatting to residents, and making visitors feel welcome. One lady said, “visiting mum here is just like being at home”. Visitors were able to help themselves to drinks, and could stay for meals if they wished. Visitors also said that they had been invited to phone Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 Page 12 the home at any time if they were worried, and said that they were kept informed of any changes in their relative’s health. Residents confirmed that the food was very good. There was a choice of menus and residents felt and could have anything they asked for. Fresh fruit and snacks were freely available. One lady commented she had gained weight since coming to live at Aldingham. Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 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 residents and visitors understood the complaints procedure and felt confident that any issue raised with the manager or senior staff, would be dealt with satisfactorily. The homes procedures and staff training arrangements were robust in helping to protect people from abuse. EVIDENCE: The home had a clear complaints procedure on display; a copy was also given to each resident or relative. Residents and visitors said they knew they could raise any issue with the manager, and although no one had made any complaint, people felt confident that if they did, the matter would be addressed. No complaints had been made to the inspector. Staff training included compulsory annual sessions on the prevention and detection of abuse and neglect. The homes’ policies and procedures on this were well understood by staff who said they had no worries about reporting any concerns to the manager or seniors. Abuse training also covered managing aggression by residents and protecting peoples’ privacy and dignity. Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 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, 20, 21, 26 The home provided a safe, comfortable, clean and well-maintained environment for people to live in. EVIDENCE: There was an ongoing programme of maintenance and decoration, which ensured the home was kept in a very good state of repair. There were plans in place to redecorate the central staircase tower, a vast undertaking, which had been dependant on other works being completed first. The grounds were well tended and therefore both attractive and safe for residents use. Since the last inspection, dividing doors between the three lounge areas had been opened up, the areas redecorated, some new furniture purchased and new flooring laid. This has enabled staff to monitor all lounge areas much more closely and has provided additional seating space, needed because of the increase in nursing clients with specialist chairs. The four residents in receipt of personal care, continued to have their meals together at one table, but did regret the loss of their own separate room. There was a separate conservatory where residents could smoke. Some people chose to spend the day in their own bedrooms. Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 Page 15 Bedrooms were all pleasant, and new furniture had been provided in some rooms. One lady said that her room had been decorated prior to her moving in, and that she had been asked to choose the curtains and blinds she wanted. Bathing facilities were very good. There were five bathrooms fitted with a variety of specialist equipment. All bedrooms had an ensuite toilet and hand basin, and there were spacious communal toilets near the lounge areas. The home was clean and fresh throughout. Cleaning staff explained their detailed rota of daily, weekly and monthly tasks, and said they had sufficient resources to complete these. During the evening when the domestics had gone, care staff knew they were responsible for clearing up any spillages to ensure safety of residents and staff from slipping. The laundry was well organised in respect of reducing cross infection, and there were clear procedures in place for handling clinical waste. Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 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, 28, 30 The number and skills of the staff group ensured that residents were well cared for at all times. Staff morale was high resulting in a positive and cheerful approach to residents needs. EVIDENCE: The staffing numbers had increased in line with the higher number and greater needs of nursing clients. Domestic, catering, administrative and maintenance staff were available in sufficient numbers to keep the home running smoothly. Staff said that any shortages due to holidays and sickness were covered and planned for in advance if possible. The company placed great emphasis on staff training and 50 of care staff had competed an NVQ. In addition to this the company provided an excellent training package for both new and experienced staff, and annual update sessions were compulsory. The training programmes were designed to meet the needs of the different staff groups; carers, registered nurses and housekeeping. This resulted in staff being confident, knowledgeable and skilled in their roles and in meeting residents’ needs. Residents and visitors described the staff as being “very caring”, “lovely” and “excellent”. One newly employed carer explained how he had completed initial induction training and was now allocated a “mentor”, (an experienced carer to work alongside him) to instruct and guide him further. Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 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 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) 31, 32, 38 The manager was well qualified and experienced to run the home. He maintained close working relations with residents and staff and ensured the home was run in the best interests of residents at all times. The comprehensive training and maintenance programmes promoted the health, safety and welfare of residents and staff in the building. EVIDENCE: The manager was experienced in care home management and had completed relevant qualifications and attended ongoing training to assist him in this role. It was clear that residents benefited from his leadership and open management approach. Residents and visitors knew him by name, said they saw him daily and could speak with him at any time. Residents and visitors were also aware of the role of the two senior nurses, and felt they could easily approach them. Staff likewise said they had good access to the manager and he was available to support them as needed. Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 Page 18 One of the senior nurses also acted as the health and safety manager for the Risedale group, a role she was appropriately qualified to undertake. Staff had received training on all aspects of health and safety at work, in relation to protecting themselves and service users from harm. A weekly inspection of the building was carried out by one of the management team to ensure that maintenance and health and safety issues were satisfactory. Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 4 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 3 COMPLAINTS AND PROTECTION 3 3 3 x x x x 3 STAFFING Standard No Score 27 3 28 4 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 4 x x x x x 3 Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 Page 20 NA 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 Good Practice Recommendations Risedale at Aldingham Nursing Home F58 F10 s6149 risedale at aldingham nh v247116 120905 ui stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Eamont House Penrith 40 Business Park, Gillan Way Penrith Cumbria, CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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