Inspection on 23/05/08 for Rivendell [Christchurch]

This inspection was carried out on 23rd May 2008.

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

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

Rivendell [Christchurch] 02/05/07

Rivendell [Christchurch] 12/06/06

Rivendell [Christchurch] 30/11/05

Rivendell [Christchurch] 06/05/05

Rivendell [Christchurch] 09/12/04

Rivendell [Christchurch] 29/06/04

Rivendell [Christchurch] 17/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Rivendell 19 Lynton Crescent Christchurch Dorset BH23 2SD Lead Inspector Martin Bayne Unannounced Inspection 23rd May 2008 10:00 Rivendell DS0000030576.V362963.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 Rivendell DS0000030576.V362963.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. Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rivendell Address 19 Lynton Crescent Christchurch Dorset BH23 2SD 01202 476663 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) Mrs Dyanne Margaret Ridyard Mrs Dyanne Margaret Ridyard Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Learning disability (Code LD) The maximum number of service users who can be accommodated is 3. Date of last inspection 2nd May 2007 Brief Description of the Service: Rivendell is a small care home registered to accommodate three people with a learning disability. In July 2007 a variation to the conditions of registration was approved for an increase in numbers from two to three residents. The registered provider, Mrs Ridyard lives at the home with her husband and two residents placed for long-term care. The third bed at the home is used for respite care for four residents known to the provider. The home is a detached bungalow in a quiet residential area. The home provides care in a family context and environment. Residents have their own bedroom, one of which is en-suite and share communal areas of lounge dining room, conservatory and enclosed garden. Residents have access to a separate bathroom with a shower. There is public transport to the Centre of Christchurch. The weekly fees range from £400 to £700 per week. Rivendell DS0000030576.V362963.R01.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 2 star. This means the people who use this service experience good quality outcomes. We, the Commission, carried out a key inspection of the home that took place on Friday the 23rd of May for half an hour and was then continued on Tuesday the 27th of May for three hours. The full inspection couldn’t be completed on Friday the 23rd, as Mrs Ridyard had to take one of the residents to a dental appointment. The aim of the inspection was to follow up on the four requirements and one recommendation made at the last key inspection in May 2007 and to evaluate the home against the key National Minimum Standards for younger adults. During the inspection we met with both of the long-term residents and briefly with one resident who attends for respite care. We were shown around the building and Mrs Ridyard took us through the records that the home is required to keep by Regulation as evidence of the care provided to residents. The returned Annual Quality Assurance Assessment document completed by Mrs Ridyard was also used as well as returned survey comment cards to form the judgements contained within this report. What the service does well: Residents are supported in a family setting and they receive a good standard of care. Their care needs are detailed within care plans and schedules of their normal routines. Their health needs are met through being supported to attend appointments appropriately. Residents enjoy a full life with the providers taking account of their personal aspirations and interests. Activities and leisure interests are met with residents being supported in the community. Medication is safely managed and residents enjoy a good standard of food, eating with the family members. Rivendell DS0000030576.V362963.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. The summary of this inspection report can be made available in other formats on request. Rivendell DS0000030576.V362963.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 Rivendell DS0000030576.V362963.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from their needs and aspirations being assessed to ensure that these can be met at the home. EVIDENCE: Since the last key inspection in May 2007 one resident has been admitted to the home for long-term care. This person had previously lived at another home owned by Mrs Ridyard, who was therefore aware and informed of this person’s individual needs and aspirations. This resident’s placement was funded through a local council and we saw completed assessments detailing this person’s needs as well as the care management assessment completed by a care manager. The transition and move to Rivendell took place over a long period of time with daily visits leading to overnight and weekend stays before the final move into Rivendell. During the inspection we spoke with this resident who told us they had settled at Rivendell and that their needs were being met. Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 9 Mrs Ridyard has four people who visit the home for respite care, all of whom have been coming to the home for a long period of time. Mrs Ridyard told us that before one of these people are admitted for a period of respite stay, she has dialogue with the person’s care manager to ensure that their needs have not changed since their last stay at the home. Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 10 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): 679 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from care plans being developed from assessments of need that reflect their right to make choices in their own right. EVIDENCE: We looked at the care plans both residents admitted for long-term care. The care plans were found to be detailed and had been developed from the assessment of needs. Mrs Ridyard had also developed a schedule of daily routines for both residents, so that continuity of care could be provided in the event of someone else having to take over their care. There was however no date on the care plan and no dates to reflect that care plans had been reviewed every six months as required by the standards. It is recommended that care plans be reviewed six monthly and signed if possible by the resident. Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 11 Whilst drafting of the report, we were informed that action had been taken to address this. One of the residents has communication difficulties and it is not possible to present the care plan in a format that is accessible to them. This person’s care plans provided information on non-verbal signs that indicate how that person is feeling. We were shown risk assessments that had been carried out to ensure that the risk of harm is minimised in carrying out care objectives, whilst respecting residents’ rights to make their own choices. We spoke with one resident who was able to confirm that they were supported to make their own decisions with assistance from Mrs Ridyard. Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 12 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): 12 13 15 16 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from being supported to take part in age and peer appropriate activities and being offered a good standard of food. EVIDENCE: We saw that residents had had opportunities made available to them for personal development. One resident attends college each day whilst the other attends day care services. Mrs Ridyard told us that neither resident had religious convictions and that arrangements would be made to meet needs should a person be placed with unmet spiritual needs. One resident told us how they went to dance classes once a week in the evening and on another evening they attend a social club. Mrs Ridyard told us that often on Sundays the whole household goes out to a local pub for Sunday lunch. Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 13 One resident has their own computer and television in their room and we saw evidence of games, DVDs and art equipment in the home to meet residents’ recreational needs. We found evidence that residents were supported to maintain links with family members and friends. One resident is supported to maintain links with their foster family. Residents are encouraged to take responsibility for themselves and where possible are involved in domestic arrangements around the home. One resident makes their own breakfast. Mrs Ridyard explained that there is no set menu as residents eat as part of the family and residents are involved in choosing what they would like to each on a daily basis. One of the residents was able to show us a record of meals and food provided. This reflected a varied and balanced diet. We noted that in one of the care plans one resident was being given advice and supported to eat healthily. One resident was able to tell us that they enjoyed the food provided at the home. Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 14 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): 18 19 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from being supported with physical and emotional health needs. EVIDENCE: We saw within care records that the residents are registered with a GP. On the first day that we visited the home one of the residents was being supported to attend a dental appointment. Within care records we saw that other health care needs were also being met, such as chiropody needs. Through discussions with Mrs Ridyard we found that she was aware of residents emotional needs and the support the residents required. Reference was made to these needs within care plans and how to support the residents. One relative commented that the home provided, ‘a very high standard of care and peace of mind’. Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 15 One resident has medication prescribed by their GP and Mrs Ridyard takes responsibility for administration, as the resident is not able to manage this on their own. We saw the medication administration records. These had been completed correctly with no gaps within the records. Mrs Ridyard has attended a course on safe administration of medicines. Medicines are kept in a locked cabinet and we saw that these were being stored correctly. We saw that the systems could allow for a full audit trail of medications received into the home. Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 16 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): 22 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from being as informed as possible about complaints procedures and from being protected from abuse and neglect. EVIDENCE: As reported at the last key inspection, the home has policies and procedures in place that are also provided in an accessible format. Mrs Ridyard informed us that since the last key inspection in May 2007, there had been no complaints made about the service. No concerns have been brought to the attention of the commission. At the last inspection a requirement was made that residents and their representatives should have a copy of the home’s complaints procedure. We spoke with one resident who told us how she would go about making a complaint should the need arise and it was evident that this person was aware of the homes procedures. Concerning the other resident it is acknowledged that there was no suitable format to inform the person of the homes complaints procedures. This was discussed with Mrs Ridyard who told us that this person had sufficient contact outside the home with people knowing their needs and personality for them to bring forward any concerns. We saw the complaints procedure. This provided an old address for the Commission. It was recommended and agreed that the address would be changed providing the new contact details for the Commission. Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 17 Mrs Ridyard informed that she was going on further safeguarding training with Dorset County Council later in the month. As reported at the last inspection the home has an adult protection policy and procedure that links to local safeguarding protocols. Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 18 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): 24 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a ‘homely’, comfortable and safe environment. EVIDENCE: As part of the inspection Mrs Ridyard and one of the residents showed us around the premises. We saw that all of the resident’s bedrooms were very personalised with residents being able to put up posters, have their own televisions and computers and personal effects. We found that bathrooms were clean and sanitary. We found the home to be clean and in good decorative order. We did receive one comment card that ‘general cleanliness is not always 100 , however, as reported care is provided in a family setting and residents as live as part of the family. On both days we visited, the home was clean and tidy. Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 19 We were told that thermostatic mixer valves have been fitted to the hot water outlets of baths and showers in order to protect residents from scalding water. It was noted that radiators were not covered. We were told that there was very limited risk of residents receiving burns as furniture had been positioned in front of radiators so that residents could not get burnt but that generally radiators did not get hot enough to inflict burns. It was recommended that a building risk assessment be carried out to evidence this assessment. We saw the laundry facilities for the home, which are sited away from food preparation areas. Hand washing facilities are available in the laundry area and there is suitable equipment to meet the laundry needs of the home. We also saw that the home had equipment and facilities to meet continents needs of residents. Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 20 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): 32 34 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home does not employ any members of staff. EVIDENCE: Mrs Ridyard informed that other than herself, with the support of her husband, the only time staff are employed is when Mr & Mrs Ridyard take an annual holiday, when care is provided through an agency. We discussed with Mrs Ridyard the legal requirement for the agency to supply a letter to Mrs Ridyard, informing that the agency staff had been subject the recruitment checks as detailed in schedule 2 of the regulations and that they had the experience to be able to meet the needs of the residents. We spoke with one resident who told us that they were happy with the levels of support they received in the home. Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 21 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): 37 39 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well-run with health and safety and welfare of residents promoted. EVIDENCE: At the last inspection a requirement was made that Mrs Ridyard commence the Registered Managers Award. Mrs Ridyard told us that she had enrolled and commenced training for the Registered Managers Award in January of this year. A requirement was also made that Mrs Ridyard update her training in safe working practices in such areas as moving and handling, first aid, infection control and basic food hygiene. Mrs Ridyard was able to confirm that she had Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 22 booked training and with her training provider and will have completed this courses by the end of August. At the last inspection a requirement was made that in line with quality assurance objectives, surveys are carried out and that these feed into an annual development plan. We saw that surveys had been sent to people involved in care of the residents. Through the feedback from surveys and from meeting residents, we were satisfied that residents are fully involved as part of family life and that their interests were respected and promoted and that there was a commitment to developing the home. One relative commented, ‘Rivendell provides a home from home atmosphere putting a lot of emphasis on helping people to choose what they want’. Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 23 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 2 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 X 33 X 34 X 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 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 3 x 3 x 3 x x 3 x Rivendell DS0000030576.V362963.R01.S.doc Version 5.2 Page 24 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 YA6 YA22 YA24 Good Practice Recommendations It is recommended that care plans be reviewed six monthly and signed if possible by the resident. It was recommended and agreed that the address would be changed providing the new contact details for the Commission It was recommended that the building risk assessments be carried out to evidence assessments concerning radiators. 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