Inspection on 14/08/06 for Rivacre House

This inspection was carried out on 14th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Rivacre House 28/11/08

Rivacre House 28/11/05

Rivacre House 26/04/05

Rivacre House 18/11/04

Rivacre House 10/06/04

Rivacre House 13/01/04

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Sunny Bank (P.R.S.) Ltd

Ashwood Court Unit 1

Thornton Lodge

Griffin Lodge

Pathways North West

Grove Lodge Care Home

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

CARE HOME ADULTS 18-65 Rivacre House 47a Seymour Drive Ellesmere Port South Wirral Cheshire CH66 1LZ Lead Inspector Jayne Telfer Key Unannounced Inspection 14th August 2006 09:00 Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 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 Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 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 Adults 18-65. 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. Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rivacre House Address 47a Seymour Drive Ellesmere Port South Wirral Cheshire CH66 1LZ 0151 356 9299 0151 355 2693 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) Making Space Care Home 12 Category(ies) of Learning disability (1), Mental disorder, registration, with number excluding learning disability or dementia (9), of places Mental Disorder, excluding learning disability or dementia - over 65 years of age (3) Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Maximum number of 12 people with mental disorder (MD) to be accommodated Within the maximum of 12 service users, no more than 3 people aged over the age of 65 may be accommodated Within the maximum of 12 service users, 1 named person with a learning disability can be accommodated 28th November 2005 Date of last inspection Brief Description of the Service: Rivacre is a purpose-built care home for people who have mental health needs. Opened in 1992, it is run by the charity Making Space. The home is a twostorey building is located within a mile of Ellesmere Port town centre, and is in close proximity to a range of local shops and other facilities including a bus route and a railway station. Accommodation for service users comprises 12 single bedrooms located on both the ground and first floor. There is a large lounge/dining area and separate conservatory on the ground floor, and a training kitchen/small lounge area on the first-floor. This service seeks to provide support and care to service users over a medium-to-long-term period. Service users are encouraged to participate fully in the formulation and subsequent reviews of their individual care plans, as well as in the running of the home, generally; they are also supported by staff to make use of community facilities and amenities for shopping, recreation, education and healthcare. Current Fees: £382.87 to £434.02 Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection is the result of information gathered about the service from April 2006. Information included notified incidents, regulation 26 reports from the provider, resident and relative surveys and information completed by the home. The inspection also included a site visit which took place on the 14th August 2006. During the visit documents were examined, staff and residents were spoken with and discussions took place with the Manager. What the service does well: Residents are given appropriate information and have their needs assessed prior to moving into Rivacre. Residents are encouraged and supported to make decisions about their lives and are involved in the running of the Home for example, attending regular meetings and getting involved in meal preparation. Care plans are written in a person centred format – and residents are involved in their own care planning. Residents have access to and are involved in activities in the local community. Families and friends are welcomed and are able to join in activities and outings if they. Meals are plentiful and nutritious – with residents being encouraged to help prepare meals. Residents are given training to help them participate in the running of the Home. Routines are flexible at Rivacre. Healthcare needs are met and residents are supported to manage their specific health needs. Medication systems are in good order and residents are encouraged to self-medicate where appropriate. The complaint process is clear and accessible. The environment is clean and comfortable, residents have recently been involved in choosing new décor. There is a good recruitment procedure and residents are involved in this. Staff have access to appropriate training. The Manager has developed a good Quality Assurance system. The staff team are enthusiastic and motivated. Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Rivacre gives residents clear information which enables then to make a clear choice regarding moving into the Home. EVIDENCE: There have not been any new residents at Rivacre for the last four years. All current residents have a statement of terms and conditions relating to their residency and appropriate contracts. It is recommended that these statements are reviewed annually and be made more user-friendly. All residents have appropriate pre-admission assessments. The Statement of Purpose and Service User Guide are appropriate and are available in other formats – for example cassette. Other information, including copies of policies and procedures, photographs of the staff team and inspection reports are freely available in the entrance hall. See Recommendation 1 and 2. Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Individuals are involved in decisions about their lives and play an active role in the planning of care and support they receive. EVIDENCE: Resident meetings are held regularly, these are minuted and residents contribute to the agenda, and their comments and suggestions acted upon where appropriate. Residents say they are involved in meal preparation and shopping. One resident is supported to manage the risk of his alcohol consumption, which is balanced against his wish to socialise with friends at the local pub. Person-centred planning has been developed at Rivacre – information about the changes is available to residents and visitors in a clearly written format. Residents are involved in their own care planning – both through the planning and review process and via a video diary, which records wishes, aspirations and decisions. Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 10 Risk assessments are in place, and these include clear management strategies. Residents are involved in their own relapse and behaviour management plans – this ranges from informing staff about various symptoms, to self-medicating. An advocacy service is used at Rivacre – with the advocate visiting the Home on a regular basis. Rivacre’s policies and procedures are freely available to residents, and they are able to comment on these during their regular meetings. Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are given opportunities for self-development and are able to participate in appropriate activities. Residents are part of the local community and engage in appropriate leisure activities. Daily routines promote independence, residents are offered a healthy diet and enjoy their meals. EVIDENCE: Rivacre makes good use of the local community – local resources such as the leisure centre and cinema are used. Two residents attend local exercise groups. Rivacre had it own allotment and residents are encouraged to participate with this and see it as their own. All residents are registered to vote. Neighbours support Rivacre and one neighbour calls over to chat and has offered to help at various functions. Various activities are available, and staff encourage individuals to pursue their own interests, for example, gardening, exercise or socialising in the Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 12 community. Families are invited to participate in outings and activities, for example one family has given a donation which has enabled a trip to Blackpool lights to take place and families are invited to take part in this. Residents are encouraged to develop independent living skills: staff teach residents to cook, residents go shopping with staff – here residents are encouraged to take charge of the shopping, for example, complete the list and stick to the budget. Rivacre does not have any home delivered food. Residents are encouraged to prepare meals with staff support. All meals are prepared freshly, and residents are enjoying participating in a healthy eating plan which has, according to the manager, had a positive impact on physical and mental health. Residents participate in training sessions regarding food hygiene, medication, health and safety and ‘what is schizophrenia’. Residents are issues with certificates on completion of these courses. Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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, 19 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. Residents are treated with respect, dignity and given privacy as required. EVIDENCE: Individual preferences regarding personal support are well documented. Routines are flexible at Rivacre with regard to getting up, going to bed, and mealtimes. Healthcare needs are met: details of health care needs are in the individual care plan. Residents are supported to make and keep appointments: appointments are written in both the Home’s appointment diary and pinned in the resident’s bedroom along with information regarding which member of staff would be available to accompany the resident if they wish to have someone with them. The notable triggers for individual mental health problems are noted for each resident as appropriate, and staff show an awareness of the unique characteristics of each resident’s illness. Staff are appropriately trained regarding health needs – recently staff attended diabetes training when one resident had a diabetes diagnosis. Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 14 Medication is stored, administered and recorded appropriately. Residents are encouraged and supported to self-medicate. Some residents use a ‘mediwheel’ system which can be filled on a daily through to a weekly basis. One resident had medication dispensed by staff, but prepares it (crushes tablets) and takes it unaided. Stocks of medication are appropriate. Medication is clearly labelled and records are in good order – including copies of staff signatures on display and photos of individual residents on records sheets. Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents feel their views are listened to and acted upon. Residents are protected from abuse and self-harm. EVIDENCE: There has been one complaint since the last inspection. This complaint was acted upon and investigated appropriately. The complaint was not upheld. There is an open culture at Rivacre regarding suggestions and complaints. There is a suggestion box in the foyer for anyone to access, and the Home holds regular resident meetings. The complaint policy is appropriate and displayed. Staff are trained regarding adult protection, with the no secrets policies being displayed in the Home. There are no current adult protection issues at Rivacre. Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the Home enables people who use the service to live in a safe, well maintained and comfortable environment which encourages independence. EVIDENCE: There have been no changes to the structure of the building since the last inspection. A recent décor programme has resulted in newly decorated bedrooms and plans to decorate communal areas. Residents have been involved in choosing décor. The home was seen to be clean, comfortable and well maintained. The exterior of the home is well maintained and fits in with the local community. Rivacre has a pleasant garden area. Communal spaces are in good decorative order and fixtures and fittings are of high quality. Bathrooms and toilets are appropriate for the needs of the residents. The building is domestic and homely – with comfortable seating and appropriate lighting. The main lounge is welcoming and friendly. The upstairs Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 17 lounge had a small kitchen which is used for rehabilitation, and provides a quiet space for meetings, visits and one to one discussions. Rivacre is clean, safe and well maintained. Residents see the building as their own home, they are free to access all areas, and were seen to feel comfortable enough to move around the house in their dressing gowns. Rivacre displays appropriate information for visitors and residents. There is a separate and appropriate smoking area. Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 35 and 36. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A competent and qualified staff team supports residents. Residents are protected and involved in the Home’s recruitment practices. Staff are appropriately trained and are well supported and supervised. EVIDENCE: There is a well-developed recruitment procedure at Rivacre: residents are involved in the interview and selection process. Appropriate information was held on staff files. Rivacre is fully staffed, and only uses Agency staff on a limited basis. Only certain staff, who have undergone the Rivacre induction programme are used from the Agency. There is a good mix in the staff team with regards to gender, skills and experience: from people who have undergone social work training to people with lots of experience working with individuals with mental health problems. Training is prioritised, with staff being very enthusiastic about accessing training. The Manager encourages training; all the staff have personal development portfolios. Training includes: equality and diversity, impact assessment, train the trainer, first aid, induction, health and safety, Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 19 supervision skills and manual handling. Training is also accessed through the Primary Care Trust and includes: diabetes and care of the dying. Staffing levels are appropriate to the needs of the residents. Rivacre uses a keyworker system to ensure individuals have needs met. Staff were observed to interact well and positively with residents. Staff meetings are used positively and provide a forum to discuss practise, polices and service development. Staff are supervised regularly and supervision includes training plans, personal and service development. Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management of the Home is based on openness and respect, has effective quality assurance systems developed by a competent and qualified manager. The health, safety and welfare of residents is promoted and protected. EVIDENCE: A Manager has been appointed and is proceeding with the registration process. The Manager has the appropriate qualifications and is keen to continue to develop his knowledge and skills – he attends various training courses and legislation updates. He has a good knowledge regarding the running of the service and this includes finances – he holds a budget for Rivacre and is highly involved in fund raising – working outside his set hours to participate in fund raising events. Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 21 Both residents and staff commented on the manager’s leadership skills, saying he was a good listener, acted on suggestions and comments, was enthusiastic and motivating and gave the Home a clear sense of direction. One resident commented that the Home was ‘much better’ since this Manager had been in place. The staff team were enthusiastic regarding the implemented changes and said that this was down to the Manager – they felt supported and motivated. The manager has a good knowledge of practices and is keen to share new learning with the staff team – he recently completed a ‘Person-Centred Planning’ course and this had been cascaded to the staff team and was being implemented as practice sat Rivacre. Staff meetings are used to disseminate information and share training. Notices regarding best practice in mental health are clearly displayed in the office. Positive comments about the manager and the developments at Rivacre are stated in the regular visit reports by the Provider. Residents have full access to their records as they wish. Residents are supported to manage their own finances – with one resident being supported to access online banking using Rivacre’s computer system. Records are kept to a high standard and staff have knowledge of the Data Protection Act. Health and Safety practices at Rivacre meet standards and there are no preventable accidents to date. Good risk assessments are completed and updated regularly. Safety checks are up to date and legislation is complied with. A recent Food Standards Agency inspection gave Rivacre a good score of 9 out of 10. The Quality Assurance system has been further developed by the Manager – he stated that the organisation is planning to use his system in all of their homes. The completion of an Annual Development plan and review system was discussed and it is recommended that this be implemented. See Recommendation 3. Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 3 3 x 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 4 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 x 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 x 4 4 4 X X 4 x Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 23 no 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. 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 2 3 Refer to Standard YA5 YA5 YA39 Good Practice Recommendations It is recommended that the statement of terms and conditions for residents be reviewed annually. It is recommended that the statement of terms and conditions is made more user-friendly. It is recommended that and Annual Development Plan is completed using information gathered as part of the Quality Assurance process. Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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. Extracts may not be used or reproduced without the express permission of CSCI Rivacre House DS0000006670.V298700.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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