Inspection on 26/09/05 for Risedale At St George`s Nursing Home

This inspection was carried out on 26th 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 St George`s Nursing... 07/06/07

Risedale At St George`s Nursing... 12/01/06

Risedale At St George`s Nursing... 19/01/05

Risedale At St George`s Nursing... 02/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Ruskin Lodge

Bushell House

Langrigg House

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

CARE HOMES FOR OLDER PEOPLE Risedale At St Georges Nursing Home Albert Street Barrow in Furness Cumbria LA14 2JB Lead Inspector Jenny Donnelly Unannounced 26 September 2005 09:00 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 St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 ui stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Risedale at St Georges Nursing Home Address Albert Street Barrow in Furness Cumbria LA14 2JB 01229 870050 01229 822955 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 Joanne Robinson Care Home 47 Category(ies) of 47 OP - Old Age registration, with number 2 TI - Terminally Ill of places 3 PD - Physical Disability Risedale At St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 ui stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 47 service users to include: up to 3 service users in the category PD (physical disability) up to 2 service users in the category TI (terminally ill) 2. One service user under the age of 65 years may be accommodated in an intermediate nursing bed within the overall number of registered places. 3. 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 19 January 2005 Brief Description of the Service: Risedale St Georges is run by Risedale Estates Ltd and the registered manager is Joanne Robinson. The home is situated in the town of Barrow-in-Furness, a short distance from the shops and amentities. The home is purpose built with accommodation on two floors served by a passenger lift. All bedrooms are single with en-suite toilets. There is plenty of lounge and dining space and there are six bathrooms with specialist equipment. There is a pleasant garden area, with seating and a water feature. The home is twinned with Risedale at Lonsdale, and they share kitchen and laundry facilities, although the homes are managed separately. St Georges provides general nursing care, has three beds deciated to intermediate nursing care assessment, and also cares for upto eight people in receipt of continuing health care funding. Risedale At St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 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 between 09.00 and 14.00 hours. The inspection comprised of a walk around the building, and talking in private with residents, visitors and staff. Care records were inspected, as were medication records and the medicines storage. Breakfast and lunch times were observed, and the kitchen visited. The manager arrived on duty during the course of the inspection, and was able to give access to the staff files. What the service does well: What has improved since the last inspection? There were no requirements or recommendations following the last inspection, and none made at this inspection. The home has continued with its own improvement plan, which covers all aspects of the home. Since the last inspection a ceiling hoist has been fitted and successfully trialled in one bedroom. The resident involved much preferred the ceiling hoist to the traditional mobile one. There is plan now to install these in the four continuing health care bedrooms. There are also plans to replace floor coverings in the lounge areas. Risedale Estates have recently become involved in an NHS Gold Standards Framework Programme for palliative care, which reflects the company’s interest in continually improving their service. Risedale At St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 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 St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 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 St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 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, 6 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. The intermediate care unit provided an excellent service. EVIDENCE: Residents and visitors said they had been able to visit Risedale St Georges, to have a look around, and meet with the manager and staff, before choosing to move in. 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 St Georges could meet his or her care needs. Residents and visitors commented that they were “very happy” with their choice of home, had “confidence “ in and “trusted” the staff. One lady commented that she was “much happier now mum was here”. The home had a three-bed intermediate nursing care assessment unit, “Holly unit”, which was opened less than a year ago. The unit was separately staffed and had input from the intermediate care team (physiotherapists, occupational therapists, social workers and community nurses). The unit had suitable space Risedale At St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 ui stage 4.doc Version 1.40 Page 9 and equipment for the purposes of rehabilitation. The demand for these beds had reduced recently, and the intermediate care team were reviewing the admission assessment criteria. Of the people who had used this facility some had been able to return home following a period of therapy, and some had gone on to require long term care in a residential setting. Risedale At St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 ui stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, 11 The health and personal care needs of residents had been assessed and clearly recorded. There was evidence that people were receiving very good general and specialised health care. The management of medicines in the home was also good and benefited residents’ general health and wellbeing. EVIDENCE: Care plans gave clear and 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. Some visitors came to the home daily and liked to be involved in their spouses or parents personal care. The staff did not expect this help, it was a personal choice by the individuals’ concerned, and involved hairdressing, shaving, and helping with meals. One lady said she liked to “set mums’ hair” after the carers had washed it. The home kept detailed health records, which showed that residents had been able to see their doctor, dentist, chiropodist and optician as required. Input from other professionals such as social workers and therapists had also been recorded. Visitors said they had been kept well informed of any changes. Safety instructions such as the use of hoists, bed rails and other specialist equipment had been clearly recorded. Health needs, including records of wound care, dressings, catheter or feed tube care were detailed and up to date ensuring staff gave consistent and correct care at all times. Risedale At St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 ui stage 4.doc Version 1.40 Page 11 Many residents were unable to contribute to the inspection, but those that could, described their care as “excellent”, “couldn’t be better”. The home had four bedrooms dedicated to continuing health care, but will take up to eight people on this basis. Those people in receipt of continuing health care funding had been allocated staff hours according to their assessed needs. Some of these residents required a high level of intensive nursing care and the home was managing this very well. 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. The home is registered to provide terminal care, and as such staff had received additional specialist training on this. The company was also taking part in an NHS Gold Standards Framework Programme on palliative care, which was reflective of their wish to continually update and improve their practice. Risedale At St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 ui stage 4.doc Version 1.40 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 standard(s) 13, 15 The home positively promoted contact with friends and family, which helped residents maintain their friendships and community links. The provision of meals was very good, with choices and variety. Specialist dietary needs were catered for without any fuss. EVIDENCE: It was clear that visitors felt welcome in St Georges and were known to and familiar with the staff. Visitors were free to make drinks in the kitchenette for themselves and the person they were visiting. The home was happy to provide meals for visitors and some regularly ate with their relatives, especially those who were elderly themselves or had travelled a distance. The manager placed an importance on caring for the whole family not just the resident. The provision of meals was very good. Residents were able to choose from a varied menu, individual preferences were known by the staff, and special needs were catered for without any problem. Staff were available at meal times to assist residents and ensure everyone had enough to eat. Drinks were freely available at all times. The kitchen was well managed, equipped and staffed appropriately. Risedale At St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 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 homes’ procedures and attitude to concerns and complaints helped people to raise any issues that concerned them. The staff training programme on abuse was robust and served to protect people. EVIDENCE: The homes’ complaints procedure was on display and a copy had been issued to all residents or their relatives. It was clear and simple to follow, and those residents and visitors spoken to were aware that they could raise concerns with any of the senior staff. Visitors said that any issues raised in the past had been dealt with promptly and satisfactorily. The manager kept paperwork relating to complaints received, which showed the outcome of any investigation and what action she had taken to rectify any problem. No complaints had been made to the inspector. There was compulsory annual update training on abuse, and staff felt confident in how to prevent and detect abuse or neglect. Staff were also clear on allowing people to express choices in how their personal care was delivered, and there was a strong emphasis on this being the residents home, run for their benefit. Risedale At St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 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, 22, 26 The home provided a comfortable, clean, safe and well-maintained environment for residents to live in. There was plenty of specialist equipment to assist residents with disabilities. EVIDENCE: St Georges is a purpose built care home, fitted with lifts, hoists and adapted bathing and toilet facilities. There is an ongoing programme of decoration and maintenance so the standard of décor and the fabric of the building are kept in good order. There are large dining lounges, plus smaller quiet rooms, which enable residents to opt in or out of social activities as they wish. There is a separate lounge diner for the intermediate care clients. There is a garden area with seating and a water feature. Bathrooms are spacious and well equipped with adapted bathing and showering facilities. Residents had been assessed and provided with the equipment they need, such as specialist mattresses, hoists and mobility aids. The intermediate care unit accessed equipment from NHS loans as required. A new overhead hoist had been fitted in one bedroom on trial. The resident concerned preferred this to the freestanding mobile hoist Risedale At St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 ui stage 4.doc Version 1.40 Page 15 and the staff also found it easier and quicker to use. There are now plans to purchase three more of these hoists for the continuing health care bedrooms. The home was exceptionally clean throughout, and there were enough domestic staff to maintain this standard. The home had good procedures to control the spread of infection, and the laundry was well organised. Risedale At St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 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, 29, 30 The number and skills of the staff group ensured that residents were well cared for at all times. The training programmes resulted in staff being confident, knowledgeable and skilled in their roles and in meeting residents’ needs. EVIDENCE: The number and skills of the staff on duty were appropriate to meet the needs of residents. The manager was able to adjust staffing levels according to changes in peoples’ needs. The two floors, continuing care and intermediate care were staffed separately, and although there was some movement of staff between areas, residents and visitors said they knew their staff group. One visitor commented, “all his favourite staff are on today”. Staff training was given a high priority and staff were able to talk about the quality and frequency of update training received. Many care staff had completed or were completing an NVQ. Nurses had been able to attend specialist training at an advanced level, which had a positive impact on the quality of care provided. 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. A newly qualified nurse said she was being well supported by senior staff and had a good planned induction programme set out for her. Inspection of staff files showed that new staff had been properly vetted as suitable before commencing in post. Visitors described the staff as “lovely” and “friendly”, and felt they were trustworthy and reliable. Risedale At St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 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, 35, 36 Residents live in a well managed home and benefit from the positive approach and leadership skills of a competent home manager, who puts residents interests first at all times. EVIDENCE: The manager was well-qualified and competent to run the home, and did so in the best interest of residents. She in turn was well supported by the directors of Risedale Estates. Residents and visitors knew the manager and other senior staff by name. There was an “open door” management policy and visitors knew they could call into the office at any time, and were seen to do so. Staff felt they knew what was expected of them and said they could raise their ideas and suggestions with the manager. The home had a safe system for handling any residents’ money that was held for safekeeping, and when checked the records and monies balanced. Care staff were being well supervised, both in daily practice and through more formal one to one meetings with their senior every two months. Risedale At St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 ui stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 4 4 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 4 4 3 x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 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 3 x x 3 3 x x Risedale At St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 ui stage 4.doc Version 1.40 Page 19 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 St Georges Nursing Home F58 F10 s6152 risedale at st georges v247764 260905 ui stage 4.doc Version 1.40 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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