Inspection on 02/11/05 for Risedale At Lonsdale Nursing Home

This inspection was carried out on 2nd November 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 Lonsdale Nursing Home 23/05/07

Risedale At Lonsdale Nursing Home 15/02/06

Risedale At Lonsdale Nursing Home 14/10/04

Risedale At Lonsdale Nursing Home 05/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Risedale At Lonsdale Nursing Home Albert Street Barrow In Furness Cumbria LA14 2JB Lead Inspector Jenny Donnelly Unannounced Inspection 02 November 2005 09:30 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 Risedale At Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 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 Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Risedale At Lonsdale Nursing Home Address Albert Street Barrow In Furness Cumbria LA14 2JB 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 870050 01229 822955 Risedale Estates Limited Mrs Alison Knagg Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45) of places Risedale At Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Independent wheelchair users must only be accommodated in the following single bedrooms: 12; 14; 15; 27; 28; 30; 32; 33; 34; 35; 36; 37; 38 and 39 The home is registered for a maximum of 45 service users to include: up to 45 service users in the category of OP (Older people over 65 years of age) The home may at any time accommodate up to 3 people under the age of 65, within the overall number of registered places. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 14th October 2004 2. 3. Date of last inspection Brief Description of the Service: Risedale Estates Limited operates Risedale at Lonsdale Nursing Home. The registered manager is Mrs Alison Knagg. This is a 45 bed nursing home which shares the site with its sister home, St Georges. Both homes are registered and managed separately, but share the main kitchen and laundry. It is situated in the town of Barrow in Furness, a short distance from the main shops and amenities. Lonsdale is purpose built over two floors and has a passenger lift. There is a mixture of single and double bedrooms, each with en-suite toilet and wash hand basin. There is a large dining/lounge on each floor, a conservatory and a small sitting room. There are five bathrooms with specialist bathing facilities. There is garden area with seating and a water feature. Risedale At Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out throughout the morning and lunchtime period. The registered manager was not present. The two senior nurses were on duty. The inspection comprised of a tour of the building, and meeting and talking with residents, visitors and staff. Care records were inspected. A complaint investigation was undertaken as part of this inspection. What the service does well: What has improved since the last inspection? What they could do better: No requirements or recommendations are made following this inspection. This is a well-managed care home. The manager and Risedale Estates continually work to meet the National Minimum Standards. The home has a learning and quality checking culture, which has a positive effect on the residents’ experience. No requirements were made in relation to the complaint investigation, although the complaint was upheld. This was because the manager had already made changes to improve this. Risedale At Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 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 Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 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 Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 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): 1 and 3 There was good information available for prospective residents and their families. Residents’ care needs had been fully assessed. Residents and their families knew the home would be able to meet their needs before they moved in. EVIDENCE: The home had a Statement of Purpose and Service User Guide on display. These gave current and prospective residents and visitors a lot of information about Risedale as a company, and Lonsdale in particular. There were copies of pre-admission assessments on file, which the manager or senior nurse had completed. In addition, there was information from residents’ social worker, community nurse and a copy of any hospital discharge information. The pre-admission assessment was very thorough, and gave a clear outline of the persons’ care needs. This enabled the staff to be fully prepared to receive new residents, and to have any necessary equipment in place. Risedale At Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 Page 9 The admission procedures for short stay respite care had been recently improved. An allocated health care assistant now accompanies the nurse to do the initial assessment. That carer is then on duty when the person arrives at the home to settle them in. For regular respite clients, a courtesy telephone call is made a couple of days before the planned admission. This is to check and update information from the last admission, and highlight any new problems or concerns. This was working well and gave residents and their families’ confidence in the home. Risedale At Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 Page 10 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 10 The home was successfully meeting the health, personal and social care needs of residents. Residents felt they were being treated with dignity and respect by the staff. EVIDENCE: Since the last inspection the home received a complaint about the standard of respite care provided. This related to personal hygiene and wound care. The company had accepted the complaint and given an unreserved apology. The manager then completely changed the whole process for managing respite care. There was clear evidence at this inspection that residents, including those on respite, were receiving good care. Care plans for long stay residents had always been good and continued to be so. The care plans for people having short respite care, had been brought up to this same standard. There was evidence of good liaison with residents’ doctors, community nurses and their families, over health and care issues. Risedale employ specialist nurses for wound care, diabetes, palliative care, continence and health and safety. Lonsdale is currently involved with an NHS Gold Standard Framework project for palliative care. Risedale At Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 Page 11 Residents said they felt well cared for at Lonsdale; “the girls are lovely”, “they do everything for you”, “they always come to see if I’m alright”. Staff had received training on protecting residents’ privacy and dignity. This was referred to in peoples’ care plans where appropriate. Staff were seen and heard knocking on residents’ doors and speaking with people politely and respectfully. “Dignity” blankets were used to cover people whilst they were hoisted. Risedale At Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 Page 12 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, 13 and 15 There was good provision of social activities for those residents who wished to join in. Residents enjoyed their meals and said they had good choice and variety in the menu. EVIDENCE: Lonsdale employed an activities organiser who arranged group activities as well as spending one to one time with the less able residents. There had been a competition for the best-decorated Halloween lounge, which residents and staff had done together. Residents said the hairdresser came every week, and many were looking forward to that today. The home had a trolley shop, which was wheeled round to each resident, so they could buy toiletries and sweets. There were also shopping trips out, generally to one of the large supermarkets nearby. Visiting times were not restricted, unless at the wishes of the resident. Lunch was observed. The days’ menu was displayed and showed two choices of main course. Residents were clearly enjoying their meal and said; “we have a very good cook”, “the meals are lovely”, “I enjoy all the puddings”, “I have special meals”. One person said they would like more chips, but also said they were trying to lose weight. There were plenty of staff in the dining rooms at lunchtime, serving the meals and giving assistance where needed. Risedale At Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 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 The manager listened to residents/families concerns, took complaints seriously and acted promptly to put things right. EVIDENCE: The home had a complaints procedure, which was on display. A copy had also been given to each resident/family. A complaint had been made earlier this year, to Risedale and to the inspector, about the quality of respite care. The manager had met with the complainant, and along with Risedale’s director of nursing, had undertaken a thorough investigation. The manager acknowledged that the care on that occasion had not been of the standard expected and gave a full apology to the family concerned. Following this incident the manager has made many changes to the management of respite care. The inspector had been informed of this complaint, both by the complainant, and by the home manager. The inspector’s investigation found that the complaint was upheld. However, no requirements were made as the manager had taken this complaint very seriously, followed Risedale’s complaint procedure exactly and done all she could to prevent this from happening again. The residents spoken to either knew about the complaints procedure, or said they would see the manager of they had any problems. Risedale At Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 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 and 20 Residents lived in a safe, comfortable and well-maintained environment. EVIDENCE: Risedale at Lonsdale is a purpose built care home. There are two floors, separately staffed and served by a passenger lift. The building has been well maintained and kept in a good state of decorative repair. There was a planned programme of general maintenance and equipment checks. The maintenance man dealt with any running repairs as they arose. The home had plenty of space, comprising of two large lounge/diners, a conservatory and a small sitting room. Both lounge/diners had a beverage area where staff and visitors could make drinks. There was a separate hairdressing salon. The furniture and furnishings were of a good standard, and were comfortable for residents. The garden and patio areas were well maintained, seating and sunshades were provided for use during nice weather. Risedale At Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 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 The numbers and skills of the staff on duty, was appropriate to the assessed needs of the residents, and the size and layout of the building. EVIDENCE: The home provided registered nurses and health care assistants in sufficient numbers to meet the needs of residents. At times the home was staffed in excess of that expected, in order to cater for the very high needs of some residents. The manager and senior nurses were able to adjust the staffing levels, and provide additional care hours if the need arose. The nursing and care staff were divided into teams between the ground and first floor. This enabled residents and visitors to know their staff group. Domestic, catering and maintenance staff were employed in sufficient numbers to promote the smooth running of the home. Risedale At Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 Page 16 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 Residents benefit from living in a home that is managed by an experienced and competent nurse manager. EVIDENCE: The registered manager Mrs Alison Knagg is a degree level registered nurse. She holds additional qualifications in management, care of older people, care of the dying, teaching, and she is an NVQ assessor and verifier. She was not present at this inspection due to being on annual leave. The two senior nurses present were very experienced and well able to stand in for the manager during her absence. The manager and senior nurses also received good support and direction from the Risedale directors. Risedale At Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 Page 17 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 3 X 4 X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 X X X X X X STAFFING Standard No Score 27 4 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X X Risedale At Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 Page 18 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 Lonsdale Nursing Home DS0000006151.V255744.R01.S.doc Version 5.0 Page 19 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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