Inspection on 16/01/06 for Risedale Retirement and Residential Home

This inspection was carried out on 16th January 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 Retirement and... 14/05/07

Risedale Retirement and... 29/09/05

Risedale Retirement and... 02/02/05

Risedale Retirement and... 22/09/04

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Chirnside House

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Ruskin Lodge

Ruskin Lodge

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

CARE HOMES FOR OLDER PEOPLE Risedale Retirement and Residential Home Abbey Road Barrow In Furness Cumbria LA14 5LE Lead Inspector Jenny Donnelly Unannounced Inspection 16th January 2006 10:10 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 Retirement and Residential Home DS0000022704.V271320.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 Retirement and Residential Home DS0000022704.V271320.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Risedale Retirement and Residential Home Address Abbey Road Barrow In Furness Cumbria LA14 5LE 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 839669 Risedale Estates Limited Mrs Pamela Harper Care Home 64 Category(ies) of Dementia - over 65 years of age (13), Old age, registration, with number not falling within any other category (64), of places Physical disability (2) Risedale Retirement and Residential Home DS0000022704.V271320.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The service may accommodate sixty four older people (64OP) thirteen of whom may have dementia (13DE(E)). The home is registered for a ten bedded intermediate care unit. The two physical disability beds are applicable to the intermediate care unit only. 29th September 2005 Date of last inspection Brief Description of the Service: Risedale Retirement and Residential Home is run by Risedale Estates, which operates four other care homes in the area. The registered manager is Mrs Pamela Harper. The home is a two-storey building, which has been extended and modernised to suit its present use. It is situated on Abbey Road in Barrow in Furness, with easy access to public transport and local shops. The full town centre amenities are quite close by. The home has sixty single and two double bedrooms, mostly with full en-suite facilities, including an assisted bath with shower attachment. For the rooms without private facilities there were ample communal bathrooms and toilets. The home has been divided for the different categories of residents; general elderly, those with dementia and those undergoing rehabilitation. There were a number of dining and lounge areas, available for residents to use. The small garden was nicely landscaped with pleasant seating areas. Risedale Retirement and Residential Home DS0000022704.V271320.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors carried out this unannounced inspection during the morning and over the lunch time period. The registered manager was on duty at the time. We toured the home, interviewed residents and staff in private and observed lunch being served. We checked care and medication records, as well as staffing and maintenance records. The standards not assessed during this inspection, were assessed and met at the last inspection of September 2005. What the service does well: What has improved since the last inspection? What they could do better: There were no requirements or recommendations made. The manager is continually seeking to improve the service offered and consults regularly with residents to seek their views. Risedale Retirement and Residential Home DS0000022704.V271320.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 Retirement and Residential Home DS0000022704.V271320.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 Retirement and Residential Home DS0000022704.V271320.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): 3 Residents’ had been carefully assessed before being offered a place at Risedale. This process reassured people that the home would be suitable to meet their individual needs. EVIDENCE: The manager assessed all new residents, before offering them a place at Risedale. The company had devised a detailed assessment tool for this purpose. The assessment covered social, health and welfare needs, and indicated what level of care was required. Prospective residents were provided with a copy of this assessment, along with a letter confirming whether the home could meet their needs and offer a place, or not. The manager said she was looking to update the assessment tool in respect of people with dementia care needs. People admitted to the Maple Unit for intermediate care (rehabilitation) were assessed through a different process involving the intermediate care support team. Risedale Retirement and Residential Home DS0000022704.V271320.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, 9 and 10 Residents’ health and personal care needs were being met in a dignified and sensitive manner. The management of medicines was good, and those residents who were able, took charge of their own medicines. EVIDENCE: At the last inspection, we spent a lot of time looking at the delivery and recording of care on the dementia unit. This time we looked at the records of five residents in the residential are of the home. The records contained all the information necessary to assist staff in delivering consistently correct care. Assessments of nutritional need had been completed and weight charts recorded. Assessments of mobility needs and skin integrity were recorded and had been updated as changes occurred. Where aids or equipment were required, this had been clearly stated. Healthcare records had been maintained and showed that residents had been able to access their doctor, community nurse, chiropodist and dentist as required. The manager had access to advice from the registered nurses working in the Risedale nursing homes, and these included specialists in continence, wound care and health and safety. The manager could also call Risedale Retirement and Residential Home DS0000022704.V271320.R01.S.doc Version 5.1 Page 10 upon the newly appointed Risedale Clinical Nurse Manager for advice on any complex care issues. One resident said she had been out the dentist that morning, had recently had treatment to her eyes, and had a chiropody appointment for next month. Another resident said she felt “very well cared for”, and another stated staff had been very good in “dealing with my problems” and said he was “treated with dignity”. Medicines in the home were well organised, and staff were knowledgeable about individuals medicines. Some residents managed their own medication, and had been assessed by the staff as safe to do so. All staff had attended training on maintaining residents’ privacy and dignity as part of their induction programme. There was a strong ethos around this issue, and residents confirmed they were treated sensitively. All bedrooms, bathrooms and toilets had door locks fitted. The communal toilets had little reminders for residents to close/lock the door. Staff knocked on residents’ doors and waited for a reply, before entering bedrooms. Residents could, and some did, lock their rooms when they left them. Care plans also contained instructions about maintaining residents’ privacy when delivering care, and this was consistent with the language commonly used by staff. Post was delivered unopened to the residents, and the manager was looking to provide individual post boxes to facilitate this. Risedale Retirement and Residential Home DS0000022704.V271320.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): 13 and 14 Residents benefited from having the freedom to entertain visitors when it suited them, and the home had made efforts to maintain links within the local community. Residents felt they had a lot of choice in how to spend their time, and the opportunity to manage their own lives as far as possible. EVIDENCE: Residents said they were able to have visitors whenever it suited them, and were not restricted by any house rules. Visitors said they were made welcome in the home, were known by the staff, and could have drinks and meals with their relative if they wished. The home had links with the local community and residents enjoyed visits from schools and churches. Residents said the daily routines of the home were flexible and they could spend their time as they wished. Residents said they could state their preference for bed times and getting up times, and staff respected this. Activities and entertainment were optional, and residents said if they didn’t wish to participate, they did not have to. Residents meetings took place monthly, and the minutes of these were printed large and put on display around the home. The minutes showed that residents had been given Risedale Retirement and Residential Home DS0000022704.V271320.R01.S.doc Version 5.1 Page 12 opportunity to voice their views and make suggestions about the way the home operates. Residents had been able to bring their own possessions, including items of furniture into the home. There were inventory lists detailing the ownership of these items on residents’ files. Many residents had their own telephone, which enabled them to lead a more independent life, by making their own appointments and financial transactions. There was information on display telling residents about how they could access independent advice and advocacy services in the local area. Risedale Retirement and Residential Home DS0000022704.V271320.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): EVIDENCE: These standards were not inspected on this occasion. Risedale Retirement and Residential Home DS0000022704.V271320.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 and 21 Residents lived in a spacious and comfortable home, with a wide choice of communal seating and dining areas. The bathing facilities were of a very high standard with many bedrooms have a full en-suite bathroom. EVIDENCE: Risedale benefited from having plenty of communal space for residents’ use. The dementia unit had two dining lounges. The intermediate care unit also had two dining lounges. The main residential area of the home had two dining rooms and two lounges, plus plenty of smaller seating areas in the main reception, and in other wide corridors. Residents said they enjoyed sitting in these areas, as they could see all the “comings and goings”. All communal rooms were comfortably furnished, warm and welcoming. There was access to the gardens, and some ground floor bedrooms had patio doors leading out. Risedale Retirement and Residential Home DS0000022704.V271320.R01.S.doc Version 5.1 Page 15 Forty-six of the bedrooms had en-suite facilities, some with a hand basin and toilet, others with a full bathroom comprising of an assisted bath with shower attachment. There were also plenty of communal bathrooms, fitted with specialist equipment. Although the current provision of bathrooms was very good, the manager said two of the communal bathrooms were due to be upgraded, one with new style bath and the other as an assisted shower. Risedale Retirement and Residential Home DS0000022704.V271320.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): 28 and 29 Residents were being protected by the homes’ thorough staff recruitment procedures, and the home had achieved a very high level of staff with a care qualification (NVQ). EVIDENCE: The company’s recruitment procedures were very thorough, and there was evidence that the manager had adhered to these procedures when appointing new staff. There had only been two new staff employed since the last inspection, and their files were inspected. New staff completed an application form, attended for interview, and worked a voluntary assessment shift. Two written references had been obtained along with a check against the POVA list (a list of people banned from working with vulnerable adults) and a criminal records check. New staff had been issued with a short tem contract, until they completed a satisfactory probation period. The files showed that new staff had received an initial induction, comprising of some supernumerary shifts (extra to the normal staff numbers) and training in fire, moving and handling and infection control. The full training programme was attended at a later date. The home has continued to provide National Vocational Qualifications (NVQ) in care for staff. Currently 73 of staff had an NVQ at level 2 or 3, against the 50 required under this standard. This is excellent for a home with such a large staff group. Risedale Retirement and Residential Home DS0000022704.V271320.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 and 35 The home was being run in the best interests of residents, and the manager regularly asked residents for their views. Money held by the home for residents was being safely managed and fully accounted for. EVIDENCE: The home operated a quality assurance system, based on seeking residents’ views through satisfaction surveys, residents meetings, and through management audits. The last satisfaction survey was carried out in November 2005, when 50 questionnaires were sent out, and 25 returned. Any concerns or “average” comments made in the surveys were included in the manager’s improvement plan for the home, and acted on. Following the latest survey results, the manager has been working with the activity co-ordinator and senior care staff, to ensure there is better coverage of activities across all residents, and promoting bigger events as requested, rather than one to one activities. Risedale Retirement and Residential Home DS0000022704.V271320.R01.S.doc Version 5.1 Page 18 The manager carries out regular audits on the quality of the care plans, kitchen, and accident/incident reports. The manager had checked 26 care plans this month, and marked a small number to be re-checked next month, where she highlighted actions for staff to follow up. The accident audit serves to highlight any changes in the number of accidents taking place, and also alerts to any increase of accidents involving one particular resident, so preventative action could be taken. The manager holds in safe storage, spending money on behalf of some residents. There was a good system for recording this, and receipting any income and spending. The records and money of four residents was inspected, and found to be correct. The residents’ balance sheets, receipts and actual money was stored separately, not pooled together, and was audited monthly. Risedale Retirement and Residential Home DS0000022704.V271320.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 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x X 4 4 X X X X X STAFFING Standard No Score 27 X 28 4 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X x Risedale Retirement and Residential Home DS0000022704.V271320.R01.S.doc Version 5.1 Page 20 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 Retirement and Residential Home DS0000022704.V271320.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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