Inspection on 06/01/06 for Risedale At Aldingham Nursing Home

This inspection was carried out on 6th January 2006.

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... 12/09/05

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 Inspection 6th January 2006 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Risedale At Aldingham Nursing Home DS0000006149.V269361.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. Risedale At Aldingham Nursing Home DS0000006149.V269361.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Risedale At Aldingham Nursing Home Address Aldingham Ulverston Cumbria LA12 9RT 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) 01229 869203 Risedale Estates Limited Mr Graeme Redshaw Care Home 40 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (40) of places Risedale At Aldingham Nursing Home DS0000006149.V269361.R01.S.doc Version 5.1 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) Dementia care is only to be provided to service users receiving personal care, not to those receiving nursing care. To include one named person under the age of 65 years (as notified by letter). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 12th September 2005 2. 3. 4. Date of last inspection 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. Accommodation 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 landscaped 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 DS0000006149.V269361.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection began at 11am. Residents were mostly up and about in the communal rooms, having their morning coffee. Some residents remained in bed, either because they wanted to, or because they were poorly. The inspection comprised of a walk around the building, talking with residents and staff, seeing lunch and reviewing some paperwork in the office. The manager was not on duty today, and one of the two senior nurses was in charge of the shift. There were 40 residents; 36 receiving nursing care and 4 receiving personal care only. All standards not covered in this report, were inspected and met at the last inspection in September 2005. What the service does well: What has improved since the last inspection? What they could do better: There are plans in place to redecorate the central staircase tower; a vast undertaking, which has been dependant on other works being completed first. There were no shortfalls identified during this inspection, and no requirements or recommendations made. Risedale At Aldingham Nursing Home DS0000006149.V269361.R01.S.doc Version 5.1 Page 6 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 DS0000006149.V269361.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 Risedale At Aldingham Nursing Home DS0000006149.V269361.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): 2 Residents and their families had been informed about the terms and conditions of stay and the costs involved. EVIDENCE: I checked the files of residents new to the home since the last inspection. The files contained copies of the residents’ terms and conditions of stay. These detailed the level of fees, what the fees covered, and recorded who was responsible for payment. They also showed which bedroom the resident occupied. Where applicable, residents had signed their consent to occupy a shared bedroom. The resident, or their family had signed, and had a copy of the contract. The files also contained information about any funding by the local authority or health trust. There were copies of information about the laundry service and TV licence arrangements. Risedale At Aldingham Nursing Home DS0000006149.V269361.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 and 11 Residents were receiving a very good standard of personal, nursing and health care. Staff were caring and knowledgeable in looking after dying people, and took residents terminal care wishes into account. 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. 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. There was evidence that when a particular care plan or treatment had not been successful, this had been reviewed and another method tried. Risedale operated a Charter of Rights for dying people, which staff were familiar with. Staff had received training in caring for dying people, and this Risedale At Aldingham Nursing Home DS0000006149.V269361.R01.S.doc Version 5.1 Page 10 included both physical and emotional care needs. Staff confirmed they carried out very regular checks on residents who were poorly in bed, and were able to explain the care they gave, including skin and mouth care. Care plans included a section for recording residents’ wishes and plans about death and dying. These included the people to be involved, any specific religious requests, care preferences and choice of funeral director. Staff said this information was collected at a time suitable to the resident and family, and not necessarily at the time of admission to the home. Risedale At Aldingham Nursing Home DS0000006149.V269361.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): 15 Residents enjoyed the meals, saying the food was good and there was plenty of choice. EVIDENCE: The meals for the day were written up on the notice board, and showed lunch as being fish and chips. Residents had chosen whether to have the fish fried in batter, or cooked plain, and whether to have chips or mashed potatoes. Some residents had opted for alternatives, and had ham or eggs. Soft and pureed diets had been catered for. I observed lunch being served. One resident did not want the meal she had asked for, and staff changed this for something else without any problem. All staff were present at lunch time, serving food from the hot trolley and helping those residents who could not manage themselves. The mealtime was well organised with the food arriving at the expected time, and being served quickly. Staff worked in pairs, serving in the dining room, taking meals to residents in their bedrooms, and assisting with feeding. This system worked well, with all residents receiving their meals promptly. Risedale At Aldingham Nursing Home DS0000006149.V269361.R01.S.doc Version 5.1 Page 12 One resident commented that the food was never as hot from the trolley as she liked. Staff were aware of this and always heated her meal so it was extra hot. Others comments received about the food were, “it’s always lovely”, “we enjoy the meals”, and “there’s plenty to eat”. Risedale At Aldingham Nursing Home DS0000006149.V269361.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): 17 Residents were able to exercise their legal rights, and get help in doing this. EVIDENCE: Risedale respected residents’ right to access independent legal advice and support. Whilst the majority of residents, used their families for this, several residents had no family. The home ensured these residents had contact with social services department, or a solicitor. Several residents had solicitors handling their affairs, and the home sent invoices and receipts directly to them. There was information available about local advocacy and support groups, which residents could contact for advice. The home updated the electoral register each year, so that residents were registered to vote in elections if they wished. Staff said only a handful of residents chose to do so, and postal voting was arranged for them. Those residents who wished to, had their own private telephone, and could conduct their business affairs in this way. Post was delivered to residents unopened, unless other arrangements had been agreed with the resident/family. Risedale At Aldingham Nursing Home DS0000006149.V269361.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): 22, 23, 24 and 25 Aldingham had plenty of specialist equipment to enable residents to move around and be cared for safely. Residents’ bedrooms were individual, and each had been made homely and comfortable. EVIDENCE: Risedale at Aldingham was well equipped to assist elderly people with infirmities. There were passenger lifts reaching all floors. Corridors and toilets had grab rails fitted. There were five bathrooms, with a variety of specialistassisted baths. Following a recent audit of bathing facilities, three baths are to be replaced in the next financial year, with an updated and improved model. There were three mobile hoists with plenty of slings, for use around the home, plus other moving and handling equipment. The home had a generous stock of specialist mattresses, including a range of soft overlay and full alternating airwave mattresses. Aldingham is an old converted building, so the bedrooms were individual, varying greatly in size and shape. All bedrooms met the minimum space Risedale At Aldingham Nursing Home DS0000006149.V269361.R01.S.doc Version 5.1 Page 15 requirements. Some rooms were fairly dark, due to their position, whereas others were quite bright. There were 20 single and 10 twin bedrooms. Residents signed an agreement to having a shared room, which Risedale call “companion” rooms. The manager held a list of residents who wished to move to a single room, and allocated these in order as they became available. All bedrooms were equipped with adequate furniture, including clothes storage, and seating. Some new bedroom furniture had been purchased, and some residents brought their own pieces of furniture from home. All rooms had an en-suite toilet and wash hand basin. There were nurse call bells in every room. The heating and lighting throughout the home was good. Residents commented on how “warm and cosy” they felt, despite the cold weather. Risedale At Aldingham Nursing Home DS0000006149.V269361.R01.S.doc Version 5.1 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 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 and 29 Staffing levels were appropriate to residents’ needs. Residents’ safety and wellbeing was protected by the homes’ strict recruitment practices. EVIDENCE: Staffing levels on the day of inspection were in line with that expected. There were two registered nurses and seven care staff on duty. The manager was not present, having worked the previous night shift, as part of his monitoring role. One of the two senior nurses was in charge of the shift. There had been little change in staffing since the last inspection, but two carers were due to leave in March to start nurse training. Applications to fill these posts were being assessed. I inspected the files of all newly employed staff. These showed that Risedale’s comprehensive recruitment procedures had been followed correctly. All new staff completed an application form, attended for interview and worked a voluntary assessment shift. Before starting work, two references, a POVA check (a list of named people not suitable for working with vulnerable adults) and criminal records bureau check were obtained. New staff were extra to the normal staffing levels for their first week, and were each allocated a mentor (an experienced staff member to work alongside). There was a formal induction, which covered moving and handling and fire safety procedures. New staff were issued with short term contracts, which were made permanent only after a successful probation period. These procedures ensured that unsuitable people were not employed to work in the home. Risedale At Aldingham Nursing Home DS0000006149.V269361.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): 33, 35, 36 and 38 Residents were able to comment on, and affect the way the home was run, through the quality survey. Any residents’ money handled by the home was being properly managed, and the home promoted the health, safety and welfare of residents and staff. EVIDENCE: The manager conducts an annual quality survey by sending out questionnaires to each resident/family. I viewed the responses to the last questionnaire, to which there had been a high response rate. The results showed that most people rated the home as good to excellent in all areas, with very few giving an average rating for certain aspects of the service. The few negative comments centred on residents being allowed to smoke in the conservatory (there were no smokers living in the home today) and the food being hotter. Other comments received, praised the laughter and singing, support for relatives and the high standard of individual care for residents. Risedale At Aldingham Nursing Home DS0000006149.V269361.R01.S.doc Version 5.1 Page 18 The manager used the results from these surveys to plan changes and improvements to the service. The home held petty cash on behalf of some residents. The records and the money of several residents were inspected, and correct. The records showed all income and spending, with receipts attached. The money was safely stored in individual wallets named for each resident. There were records of every item purchased from the homes’ trolley shop, which matched up with residents’ spending records. The home operated a system of formal staff supervision. There was a tracking form in the office, which showed all staff received a supervision session every two months. The individual supervision records showed that a set format was used to record the session, and that care practices and training needs were discussed. Care staff said they received supervision from the registered nurses. Health and safety issues were well managed in the home. Equipment and services to the home were checked and maintained in accordance with manufactures instructions. Staff attended regular training sessions on safe moving and handling of residents and equipment, fire safety, food hygiene and infection control. Health and safety training records were available and up to date. Any accidents to staff or residents had been reported, and followed up appropriately. Risedale At Aldingham Nursing Home DS0000006149.V269361.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 X 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 X X X X 3 3 3 3 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 X X 3 X 3 3 X 3 Risedale At Aldingham Nursing Home DS0000006149.V269361.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Risedale At Aldingham Nursing Home DS0000006149.V269361.R01.S.doc Version 5.1 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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