Inspection on 06/02/06 for Risedale At Aldingham St Cuthberts Nursing Home

This inspection was carried out on 6th February 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 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 St... 29/05/07

Risedale At Aldingham St... 31/10/05

Risedale At Aldingham St... 07/01/05

Risedale At Aldingham St... 29/07/04

Similar services:

Chirnside House

Rosehill Residential Home

Ruskin Lodge

Langrigg House

Parkside

The Good Companions

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

CARE HOMES FOR OLDER PEOPLE Risedale At Aldingham St Cuthberts Nursing Home Aldingham Ulverston Cumbria LA12 9RT Lead Inspector Jenny Donnelly Unannounced Inspection 6th February 2006 12:50 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 St Cuthberts Nursing Home DS0000006150.V282902.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 St Cuthberts Nursing Home DS0000006150.V282902.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Risedale At Aldingham St Cuthberts Nursing Home Aldingham Ulverston Cumbria LA12 9RT Address 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 01229 869152 Risedale Estates Limited Mrs Julie Alexander Care Home 43 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (41) of places Risedale At Aldingham St Cuthberts Nursing Home DS0000006150.V282902.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 43 service users to include: up to 43 service users in the category of DE (E) (Dementia over 65 years of age) 2 named service users in the category of DE (Dementia under 65 years of age) may be accommodated within the overall number of registered places. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 31st October 2005 2. Date of last inspection Brief Description of the Service: Risedale at Aldingham St Cuthberts is a single storey, purpose built home for 43 older people suffering from dementia, and requiring nursing care. Risedale Estates Ltd operates the home and the registered manager is Mrs Julie Alexander. The home is built around a central square, which encompasses a secure garden to which residents have free access. There are 37 single and 3 double bedrooms, some of which have en-suite facilities. There are two large lounge diners and two other smaller sitting rooms. There are five fully adapted bathrooms with specialist equipment. The home is located in the small hamlet of Aldingham, just of the coast road between Ulverston and Barrow-in-Furness, overlooking the Morecambe estuary. The sister home, Risedale at Aldingham, is adjoined to St Cuthberts and although the homes are managed separately they do share the kitchens and laundry. Risedale At Aldingham St Cuthberts Nursing Home DS0000006150.V282902.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over lunchtime and during the afternoon. The registered manager was present, and the home was fully staffed. The inspector spoke with residents, visitors and staff. Care, medicines and staffing records were inspected, and a tour of the building was carried out. Due to the residents’ advanced dementia, they were limited in their contribution to the inspection. The inspector judged the standard of care through direct observation, reading residents’ records and through discussion with visitors and staff. Lunchtime, afternoon drinks, activities, and the general interaction between staff and residents were observed as part of the inspection process. Any key standards not reported on here, were inspected and found satisfactory at the last inspection of October 2005. What the service does well: What has improved since the last inspection? There were no requirements or recommendations made at the last inspection. The frequency of carpet cleaning in communal areas had increased, to keep pace with food spillages and continence problems. The manager continues to monitor the success of this. The programme of replacing bedroom furniture Risedale At Aldingham St Cuthberts Nursing Home DS0000006150.V282902.R01.S.doc Version 5.1 Page 6 had been completed, and all bedrooms had new matching wardrobes and cabinets. Work was being undertaken to improve the appearance of an outside area, overlooked by some bedrooms. Risedale Estates had introduced a new post of a clinical nurse manager, who is responsible for overseeing the care packages of the most needy residents in the groups’ five homes. This has given the home a valuable added resource in meeting peoples’ most complex needs. The mentoring system for coaching new staff had been strengthened, although it was already very good. 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 St Cuthberts Nursing Home DS0000006150.V282902.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 St Cuthberts Nursing Home DS0000006150.V282902.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): EVIDENCE: No standards in this section were assessed. Risedale At Aldingham St Cuthberts Nursing Home DS0000006150.V282902.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, 9 and 11 Health, personal and social care needs were carefully planned so that residents received a very high standard of all round care. The home managed medicines safely and staff were knowledgeable about each residents’ medicines. There was a charter of rights for the dying, and staff had received training on caring for and supporting dying people, and their relatives. EVIDENCE: The care records in St Cuthberts were excellent. Records clearly showed each resident’s nursing and care needs including general safety, skin/wound care, behaviour, medicines, bathing and nutritional needs. All care interventions were clearly recorded, up to date, re-assessed and re-written as the need arose. This gave staff very good guidance to follow. In addition to this were lovely “pen portraits” showing a brief history of residents’ lives, loves and interests. These helped staff enormously see past the dementia to the person. The care plans also contained the details that mattered to each resident; the clothes they liked to wear, preferring a shower to a bath and whether they liked to be touched or not. Care plans told a story about each person and were not just a list of things to be done for them. Risedale At Aldingham St Cuthberts Nursing Home DS0000006150.V282902.R01.S.doc Version 5.1 Page 10 The management of medicines was good. There were full records of receipt of medicines into the home, their administration and any disposal. The medicine administration charts had been fully and accurately completed by staff. The medicine stock was safely and tidily stored, with all items clearly labelled. Staff were knowledgeable about residents medication and understood what “as required” medicines were for, and when to use them. There was evidence of medication reviews having taken place, and where medicine-reducing regimes were in place, the instructions for staff were clear. For the care of dying people, Risedale estates had a “charter of rights”, describing how people, including residents’ family, should be cared for. Care plans contained information about peoples’ wishes around dying and any specific after death arrangements. All staff had received training on caring for the dying, which included physical and emotional care needs. Any move into hospital or into a non-dementia nursing facility, were fully discussed with relatives, to seek the best outcome for the resident. Risedale At Aldingham St Cuthberts Nursing Home DS0000006150.V282902.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): 14 Staff promoted and respected residents in making choices and decisions in their daily lives. Choice was mainly centred on meals, activities and the way in which care was delivered. EVIDENCE: Residents were limited by their dementia in exercising full choice and control over their lives. However, small choices in day to day living were clearly being offered and respected. Staff were seen to offer residents choices at meal and drink times, and whether to join in activities or not. It was evident that when a resident declined to participate in any activity, be it a social or care activity, staff respected this, left the resident and offered the care at a later time. Residents were able to wander freely around the home and have access to a secure garden. St Cuthberts does not normally operate an internal door locking policy. The manager prefers people not to be frustrated by coming to locked doors at every turn. On this occasion though, bedroom doors were being locked when the resident was not in their room. This was a temporary arrangement to help a new resident settle into the home, and into her bedroom. Risedale At Aldingham St Cuthberts Nursing Home DS0000006150.V282902.R01.S.doc Version 5.1 Page 12 Throughout the inspection residents were seen spending their time as they wished. Most residents ate their lunch in one of the dining rooms. Afterwards some joined in a quiz activity in one lounge, while others watched a film in another lounge. Some residents went to their bedroom for an afternoon nap. Staff said the afternoon was a fairly peaceful time, with residents becoming more active and vocal by teatime. Risedale At Aldingham St Cuthberts Nursing Home DS0000006150.V282902.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): 18 Staff were protecting residents from harm, and promoting their emotional and physical well-being. EVIDENCE: The home had policies and procedures on adult abuse, which detailed what is abuse and what action to take if an abuse is suspected. All staff had attended training on this subject, both as part of their initial induction and through compulsory updates. The training comprised of two sessions, one about abuse and one about managing challenging behaviour by residents. Staff at St Cuthberts received a more in-depth training on both these issues than the other Risedale homes, because of the residents’ increased vulnerability. The home manager provided the abuse and challenging behaviour training, and advice, to the other care homes in the Risedale group. It was evident from the way staff interacted with residents that choices were offered, and any refusals by the resident were accepted without fuss. There was no expectation that residents must fit in with the routines of staff. The manager and staff promoted a peaceful atmosphere in the home that had calming effects on the residents. Incident reports showed the home had very few incidents of residents displaying challenging behaviour, or showing aggression toward each other or to staff. Care plans described how staff should respond to individuals with challenging or repetitive behaviour, so the resident received a consistent response and staff could properly evaluate if the plan worked. Risedale At Aldingham St Cuthberts Nursing Home DS0000006150.V282902.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): 20, 24 and 26 Residents benefited from living in a clean, comfortable and well-maintained environment, which had been nicely decorated and furnished. EVIDENCE: Since the last inspection, the frequency of cleaning the lounge carpets had increased. The carpets were clean and fresh at this visit. Work was being undertaken to an outside area, where builders were clearing trees from a steep bank to let in more light, and putting in terracing and planting, to make the area more attractive. This area was not accessible to residents, but was visible from some bedrooms. The home had 37 single and 3 double bedrooms, 19 of which had en-suite facilities, with wash hand basins in the remainder. Over the last year or so, the home had been replacing the older bedroom furniture. All bedrooms were now furnished with new wardrobes and matching cabinets, which looked smart. Signage around the home was good, with toilets and bathrooms having pictorial signs for residents to recognise easily. Bedroom doors had pictures of the residents’ choice, to help people recognise, which was their room. Risedale At Aldingham St Cuthberts Nursing Home DS0000006150.V282902.R01.S.doc Version 5.1 Page 15 The laundry was large, well laid out and staffed daily. Dirty washing was brought in through one door and moved through the washing, drying, and ironing areas, before leaving through a second door. This system helps prevent cross infection, by keeping clean and dirty items well separated. The laundry staff were equipped with gloves and aprons, and had clear instructions on how to deal with infected or foul laundry. Residents’ clothing was well presented, clean, mended and suitably ironed. Domestic staff were on duty daily, and the level of general cleanliness and hygiene around the home was good. Visitors commented that the home was always clean. Risedale At Aldingham St Cuthberts Nursing Home DS0000006150.V282902.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): 29 The homes’ recruitment procedures protected and promote residents’ wellbeing. EVIDENCE: Risedale Estates operates thorough recruitment procedures. Inspection of new staff files showed that St Cuthberts’ had adhered to these procedures. All new staff complete an application form, attend for interview, and work a voluntary assessment shift. Written references had been taken up and a criminal records bureau check had been completed, before the person was offered the job. There was evidence that new staff worked induction shifts, where they were extra to the usual staff numbers, and worked alongside experienced staff. The home had just introduced a new mentorship programme, which extended and formalised the current induction period. This had been devised and implemented, through a health care assistant working party. St Cuthberts had a stable staff group, with the changes mainly due to care assistants leaving to do their nurse training. Two such staff were due to leave next month, and the manager had interviews arranged to appoint replacements. Recruitment procedures were sound, and served to protect residents from having unsuitable persons working in the home. Risedale At Aldingham St Cuthberts Nursing Home DS0000006150.V282902.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): EVIDENCE: No standards were assessed in this section. Risedale At Aldingham St Cuthberts Nursing Home DS0000006150.V282902.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 X 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X 3 X X X 3 X 3 STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X x Risedale At Aldingham St Cuthberts Nursing Home DS0000006150.V282902.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? N/A 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 St Cuthberts Nursing Home DS0000006150.V282902.R01.S.doc Version 5.1 Page 20 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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