Inspection on 04/04/08 for Rivelin House

This inspection was carried out on 4th April 2008.

CSCI found this care home to be providing an Good service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rivelin House 05/10/07

Rivelin House 19/04/06

Rivelin House 10/08/05

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Rivelin House 498 Bellhouse Road Sheffield South Yorkshire S5 0RG Lead Inspector Ms Shelagh Murphy Key Unannounced Inspection 4th April 2008 09:00 Rivelin House DS0000063343.V361801.R03.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 Rivelin House DS0000063343.V361801.R03.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. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rivelin House Address 498 Bellhouse Road Sheffield South Yorkshire S5 0RG 0114 2577911 0114 2577933 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) www.milburycare.com Milbury Care Services Ltd Post Vacant Care Home 8 Category(ies) of Learning disability (8), Physical disability (8) registration, with number of places Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One specific service user with Learning Disabilities, over the age of 65, named on variation dated 2nd October 2006 may reside in the home. 5th October 2007 Date of last inspection Brief Description of the Service: Rivelin House is a care home providing personal care and nursing care for eight residents. The home is owned by Milbury Care Services Limited and is situated in the Shiregreen area, of Sheffield. It is close to local shops and amenities and on a main bus route. The home is not fully accessible for all people who are wheelchair users, as the kitchen and laundry facilities are very small. There are eight bedrooms rooms for single occupancy situated on two floors the upper floor is accessed by a lift. All bedrooms have an en-suite facility accessible for wheelchairs and fitted with overhead tracks for hoists. One of the rooms has its own kitchenette, lounge/dining room, bedroom, ensuite and its own fenced garden area. The garden areas are accessible to all residents, these areas are private and appropriate garden furniture is provided. The scale of charges ranges from £1700 to £3400 per week. Additional charges include travel costs, hairdressing, social activities, additional meals and holidays. Prospective residents and their families can get information about Rivelin House by contacting the home manager. Copies of the statement of purpose, the service users’ guide and the latest CSCI inspection report are also available. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is a 2 star. This means that the people who use this service experience good quality outcomes. This visit was unannounced; it took place over one day between 9am and 3.30pm. We spent a total of six hours on site. In the report we make reference to “us” and “we”. When we do this we are referring to the inspector and the Commission for Social Care Inspection. We used a variety of information as well as our findings from the visit to assess the quality of service offered to people who use this service. During the site visit we interviewed one person who lived at the home and made observations of how the staff spoke to and interacted with people in their own home. During this visit we also spoke to three carers/support workers, the deputy manager and a team leader. We did this to gauge their views of the service. Gillian Mulhearn, the manager, assisted with our visit, she was given some feedback information at the end of the visit. Throughout the visit we looked at the environment, and made observations about how appropriate the environment was to meet peoples needs. We also checked some samples of documents that related to peoples’ care and safety. These included needs assessments, daily record, care plans, risk assessments and staff supervision notes and recruitment files. Before the visit the registered manager had completed an Annual Quality Assurance Assessment (AQAA). We have used some of this information within the report. Before the site visit to the service we also looked at a range of other information we had received about the service since the last inspection. This includes information provided by local authority agencies, the homes monthly reports, adult protection referrals and complaints made about the service. We sent out the following surveys to gauge peoples’ views of the service: • • Five people who use the service were sent surveys (in picture formats) none of these were returned to us. Five staff that work at the service were sent surveys and none of the surveys were returned. DS0000063343.V361801.R03.S.doc Version 5.2 Page 6 Rivelin House • • Five relatives were sent surveys and none were returned. Five different health/social care professionals comment cards were sent out and none were returned. We have worked in partnership with Sheffield Safeguarding Adults team in order to ensure that all safeguarding concerns at the service are addressed. This is ongoing. This was a key inspection and we checked all the key standards. The inspector would like to thank the people who live at the service and the staff for their co-operation during our visit. What the service does well: What has improved since the last inspection? People had individual plans, which met their needs. People’s individual plan formats had been changed since the last inspection and were now more person centred in their approach. People were observed to be involved in meaningful daily activities. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 7 Since the last inspection the support offered to people to maintain contact with their relatives and parents has improved People said they enjoyed the food on offer at the home. One person showed us the picture menu in the dining room, which, staff had devised to show people what choice of meals are available. Staff told us that personal care support was offered to people on an individual basis and was flexible to meet people’s needs. For example, rising and retiring times were dependent on the individuals choice. The home has a complaints procedure for people. This is in accessible formats; it was called, `letting us know what you think’. All of the staff we spoke to said they were aware of the adult protection procedures and they had completed training on this subject. This will better protect people. The inspector checked a sample of two people’s finance records. The system was easy to follow and gave a clear account of their deposits and withdrawals. This protects people’s rights. During a tour of the premises we observed the home was clean, well decorated, safe and homely. The home has an effective staff team; with sufficient numbers of staff to support peoples assessed needs. This enabled the staff to work effectively as a team in order to deliver safe and dignified care to all the people they support. The manager and the staff training records confirmed, that all of the present staff had induction training and completed the required mandatory training. This ensured that staff had the appropriate knowledge and skills to support people. People are benefiting from a well run home. People are more involved in the development of the service and the health, safety and welfare of people is being promoted. What they could do better: People with communication needs, which are not met, must be referred for speech and language assessments to ensure the staff understand when people are trying to communicate their needs and wants. Medication systems need to be more closely monitored to ensure that all medication administered is signed for and recorded appropriately. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 8 One issue, which, needs to be addressed was the fact that people do not routinely have a key to their own room. The manager acknowledged that this is something, which will need to be introduced in the near future to protect people’s rights and privacy. 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. The summary of this inspection report can be made available in other formats on request. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 9 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 Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. People experience good quality outcomes in this area. People had their needs assessed, before they moved in to the home, identifying if the staff could meet their individual needs. This judgement has been made using available evidence including a visit to Rivelin House. EVIDENCE: We checked two people’s pre-admission needs assessments. These showed that people had assessments before they came to live at the service. Staff told us, and the deputy manager confirmed that the manager of the service was responsible for visiting and assessing peoples needs, prior to offering them a placement. This was to ensure that the staff could meet their needs and expectations. Since our last visit two people had had their needs re-assessed and we saw evidence that as a direct result of this people were now being funded to have more 1-1 staff support to ensure they are able to take part in more activities and to access the community on a regular basis. The outcome for people was they could now lead individual lifestyles with appropriate support from staff. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. People experience good quality outcomes in this area. People had individual plans, which were being implemented effectively. This had ensured that people had more opportunities to make choices. This judgement has been made using available evidence including a visit to Rivelin House. EVIDENCE: One person said they had been supported by staff to devise an individual plan, to meet their needs. They said that they met with their keyworker and named nurse every month to review their plan. We asked if we could check their plan. It contained very detailed information about the person and their needs, wants and aspirations. People’s likes and dislikes were identified and any goals the person wished to meet that month were also identified. The individual plan formats had changed since the last inspection and were now far more person centred, as was the staff’s approach towards supporting people. The manager also indicated that they were planning to ensure these plans were devised in more accessible ways to meet people’s individual Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 12 communication needs in the future. For example by using pictures and photographs. People’s communication needs were recorded in their individual plans. There was evidence that people’s individual needs were being met and staff were ensuring that people could make decisions and choices. For example; one person showed us that they had an activities board, which helped them to communicate their personal preferences to staff. We also observed staff to offer people choices, for example choice of meals, using photos for the menus. The manager stated that one person, who had limited verbal communication needed to be referred for an assessment by a speech and language. This will need to be actioned as a priority to ensure this person’s communication needs are met. We checked two people’s risk assessments, they had been reviewed over the last three months in both cases and one had been reviewed and updated last month. From speaking to staff it was clear that the management of risk is handled in a positive manner, which enables people to carry out activities whilst being aware of the risks that could be posed. For example one person who is peg fed is offered opportunities to taste foods, which they used to enjoy. The person was observed to be offered tiny amounts of ice cream, and other foods, which they really enjoyed. The staff felt this small activity had really enabled the person to enjoy food again. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 & 17 People experience good quality outcomes in this area. There were some excellent examples of how staff offered people choices and appropriate support in order to meet their individual lifestyle choices. This judgement has been made using available evidence including a visit to Rivelin House. EVIDENCE: People were observed to be involved in meaningful daily activities. One person told us they were going out to a luncheon club, which they attended each Friday. They said, “Its really good at the club, the staff take me and we have a meal and then play bingo”. Another person told us they had been out bowling the night before with staff and this had been, “really good”. A member of staff told us that they read Enid Blyton books to one person, as they had found out that they really enjoyed these stories. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 14 Other people were observed to be going to Meadowhall, a shopping centre to purchase clothes. Staff said the person, who had complex needs, was encouraged to choose their own clothes and this had encouraged the person to have more ownership of their belongings. The staff told us and we saw evidence in peoples individual plans that the staff support people to access the community on a regular basis to attend the cinema, ice-skating, local parks, bowling and shopping. The manager told us that a nurse had been given the responsibility to plan daily activities with people on an individual basis to ensure people were supported to access the community and take part in meaningful activities, whilst developing relationships with new people. Since the last inspection the support offered to people to maintain contact with their relatives and parents has improved and two people are now supported to visit their relatives on a weekly basis. The staff said this had had a very positive outcome for the person and their relatives. We also saw evidence in daily records that some people were supported by staff to phone relatives. People said they took part in domestic routines in the home. One person told us, “I vacuumed my bedroom yesterday. They also said, “We go to Asda to buy our own shopping”. Other people told us the staff supported them to do their laundry and to clean and tidy their rooms. Staff told us that some people take part in baking sessions and other people are supported to help prepare simple meals. However, the staff said they did most of the cooking for people, as the kitchen is quite small. People said they enjoyed the food on offer at the home. One person showed us the picture menu in the dining room, which staff had devised to show people what choice of meals are available. One person told us, “My favourite meal is shepherd’s pie”. “ We have good meals here”. Staff told us and we observed most people being offered a choice of menu at mealtimes. We observed staff showing people a menu of pictures of different dishes, to help people who have communication needs to make choices. Several people at the home need special diets. Each person had nutritional assessments. One person is peg fed, the staff that support this person to be fed had been appropriately trained. Two other people have been assessed as Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 15 requiring a soft pureed diet. The staff told us how they prepared the food. This was done appropriately, by not mixing the foods and presenting it well. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 People experience good quality outcomes in this area. Staff supported people to meet their health and personal care needs. This empowered people and ensured their well-being and dignity was protected. This judgement has been made using available evidence including a visit to Rivelin House. EVIDENCE: People were observed to be well dressed and their clothing was age appropriate. Staff told us that personal care support was offered to people on an individual basis and was flexible to meet people’s needs. For example, rising and retiring times were dependent on the individuals choice, as was the time when people were to be bathed/showered. One person was observed to be supported by staff to have their hair blow-dried. Overall we observed that people received personal care support in the way they preferred. Examples of this were recorded in their individual plans. Some people’s plans showed they preferred to shower/bathe each morning, other people needed support to dress but could choose their clothing etc. The manager told us that people’s health needs were recorded in a health action plan and we saw evidence of this. These plans now need to be agreed with the local G.P. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 17 People had been for health care appointments with the local G.P., the dentist and optician services. Some people had attended appointments with specialist health providers, for example neurology consultants, tissue viability nurses and specialist learning disability nurses. Two people were awaiting Occupational Therapy assessments and one person needed to be referred to a speech and language therapist. Some of the staff had been offered training by a behavioural therapy team in order to support one person who presented challenges to the service. People had moving and handling assessments in place, which had been reviewed since the last inspection. Each appropriate person had individual hoist slings with their names on to ensure their safety in the hoists. The nurse on duty told us that none of the people who lived at the home were able to administer their own medication. Therefore the nursing staff were responsible for these tasks. The medication procedures were checked. The home used the Boots (M.D.S) monitored dosage system. A nurse showed us the systems used. The medication was stored in clean, lockable drug cabinets, in the clinic room. The clinic room had been moved from out of the lounge area, since the last inspection, to make sure it was less obtrusive in the house. However, a few concerns need to be addressed to ensure people’s safety and these included an E45 cream, an anti-bacterial mouthwash and a medicated face wash had not been signed for on several occasions. On one person’s drug sheet, paracetamol had been given and signed for but the reason for this had not been recorded on all occasions. This was brought to the manager’s attention to address to ensure people’s welfare. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23 People experience good quality outcomes in this area. People’s views are now recognised and acted upon. This judgement has been made using available evidence including a visit to Rivelin House. EVIDENCE: We asked people whether they liked living at Rivelin House and this is what they said; “I like it here”, “I’m quite happy “, “The staff are good with me”. “ I like Judy best”. The home has a complaints procedure for people. This is in accessible formats; it was called, `letting us know what you think’. We asked people whether they knew how to make a complaint one person was well aware of their rights to complain and said “ I would tell Gillian” (the manager). Staff said that other people who had more profound needs would need to rely on relatives or their key workers to support them to make complaints. The manager stated in the AQAA report that no complaints have been made since our last visit in October 2007. All of the staff we spoke to said they were aware of the adult protection procedures and they had completed training on this subject. The manager also confirmed this. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 19 The home has a whistle blowing procedure at the home. We interviewed three staff; all of them were able to explain the organisations whistle blowing procedures. This was positive as it showed that this issue had been highlighted with the staff since our last visit. Over the last year two adult protection referrals have been made relating to all of the people who live at the home and are still presently under the adult safeguarding procedures of Sheffield social services. The outcome and actions to be taken as a result of these investigations will be reported on in future reports. The inspector checked a sample of two people’s finance records. The system was easy to follow and gave a clear account of their deposits and withdrawals. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30 People experience good quality outcomes in this area. Overall, the accommodation offered to people was of a high standard. People had been supported to personalise and make their houses homely and comfortable, in order to meet their specific needs. This judgement has been made using available evidence including a visit to Rivelin House. EVIDENCE: At the time of the visit five people lived at the home, four people live in the main house and one person, lives in a self contained flat. We asked people whether they liked living at Rivelin House and this is what they said; “I like it here”, “I’m quite happy “ and “The staff are good with me”. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 21 We asked people if we could see their bedrooms and were given permission for this so we checked two people’s bedrooms. The rooms were decorated to meet people’s individual tastes and were comfortable and homely. One issue, which, needs to be addressed, was the fact that people do not routinely have a key to their own room. The manager acknowledged that this is something, which will need to be introduced in the near future to protect people’s rights and privacy. During a tour of the premises we observed the home was clean, well decorated, safe and homely. The kitchen was clean and tidy, but the kitchen units still need replacing. This had also been identified by the manager in the, self-assessment report (AQAA) sent to CSCI. The kitchen and laundry rooms are not accessible to people who were wheelchair users. However, staff said they had overcome some of the issues by preparing food with people in the dining area, which is accessible to them. This offers people opportunities to take part in these tasks. The manager has recruited a cleaner since our last visit. Staff said that this had resulted in better outcomes for people, as they now were able to spend more time in meaningful activities with people. The bathrooms checked were clean and appropriately adapted to meet peoples’ needs. The flat was homely, well decorated, smelt fresh and was furnished to meet the needs of the person who lived there. There were some marks on the floor covering in the dining area of the flat, which need to be cleaned, and/or the flooring needs to be replaced as it was badly marked. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34, 35 and 36. People experience good quality outcomes in this area. People, are now supported by a staff team who have the appropriate skills and experienced, to meet people’s individual needs. This has resulted in people being offered safe and dignified care and support. This judgement has been made using available evidence including a visit to Rivelin House. EVIDENCE: Since the last inspection the manager had been successful in ensuring that people’s assessed needs were now being met by securing extra staff hours/funding for individual people who have higher levels of dependency. This has enabled staff to work more effectively as a team to support people. We observed the relationships between staff and people who lived at the home. This showed that staff had positive regard for all of the people who lived in the home, staff were respectful, in the way they spoke to and of people. We asked one member of staff how they communicated with one person who had profound communication needs. They said they watched the person’s body language and facial gestures. For example when they read to them. This was very positive to see and it was clear that this member of staff was very attentive to this persons needs. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 23 The manager and the staff training records confirmed, that all of the present staff had induction training and completed the required mandatory training. This included moving and handling, fire safety, first Aid, food hygiene and infection control. Other training that had been either planned or completed included, NVQ2 awards, managing challenging behaviour, adult protection, medication, epilepsy, communication skills and record writing skills. One member of staff we spoke to had initially worked as an agency care worker and said they had chosen to work at Rivelin House recently as they were so impressed by the management of the home, specifically because the home was organized using person centered approaches and the managers were open to staff suggestions to improve and develop the service. Three staff recruitment records were checked. We found these contained all of the information required including CRB’s, application forms, proof of I.D, and two references. This will better protect people’s welfare. The manager said and the staff confirmed that regular staff meetings were held. Minutes of the meetings were seen. Staff told us and we checked a sample of supervision records which showed that staff were regularly supervised. This had enabled the team leaders to monitor staff practices and address any problems that may arise in a supportive manner. Staff comments about the organisation were far more positive People felt well supported by the manager, they were receiving regular training and got on well as a team of staff. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards, 37,39 and 42. People experience good quality outcomes in this area. People who live at the home were benefiting from a well-run service. This is because people are now experiencing the benefits of a change in the ethos, leadership and management approach within the home. This judgement has been made using available evidence including a visit to Rivelin House. EVIDENCE: The acting manager is appropriately experienced, is a registered nurse and had completed the registered managers award. She is planning to leave this temporary post in the near future. A new manager, will need to apply to register with the Commission as soon as possible. This should encourage stable leadership and management of the home. The way the service is now managed is providing good overall outcomes, to the people who live there. The provider has addressed previous concerns in a proactive manner, for example they appointed a new line management of staff to the service. This approach has been very successful in turning this service around. The new acting manager, area manager and Director of Care have Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 25 made very positive progress over the last year in order to ensure the home is being well managed, is safer and is providing more opportunities to enable people to have fulfilling lifestyles. The staff team are now delivering care and support using person centred approaches, for example there are more staff on duty each day to enable people to have opportunities to access the community and to develop life skills. People now have behavioural management plans and staff say they feel more confident to support people as they have received training to implement these plans. The service has good health and safety policies and procedures in place and staff knowledge of these are good. It was clear during this visit that staff now feel better equipped to put these policies in to practice as they are receiving regular supervision and support from their line managers. During this visit there was more evidence of service user involvement in the way the service was developed. More information had been made accessible to people, for example the menus were pictorial, people had activity boards and a nurse had been designated to work with individuals to ensure they had planned activities on a regular basis. These practices had really improved outcomes for people in a meaningful way, which affects their lives on a daily basis. The area manager had carried regular monthly monitoring visits to support the development of the service. The home has appropriate health and safety policies in place. It was positive to see that previous concerns around health and safety issues had been addressed and no breaches of the regulations were seen during this visit. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 26 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 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes. 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 YA20 Regulation 13 (2) Requirement When recording that medication has been administered, as required, staff must record the reasons for this clearly to protect people’s welfare. (Requirement not met 31/12/07) Timescale for action 30/05/08 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 YA25 Good Practice Recommendations People should be offered a key to their bedrooms if this is appropriate to meet their individual needs. This will better protect their rights. Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Rivelin House DS0000063343.V361801.R03.S.doc Version 5.2 Page 29 - 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. 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