Inspection on 08/12/05 for River View Care Centre

This inspection was carried out on 8th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

River View Care Centre 22/05/08

River View Care Centre 16/04/07

River View Care Centre 24/07/06

River View Care Centre 18/06/05

River View Care Centre 15/12/04

River View Care Centre 20/11/04

River View Care Centre 30/09/04

River View Care Centre 17/09/04

River View Care Centre 08/09/04

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

CARE HOMES FOR OLDER PEOPLE River View Care Centre Rodway Road, Off Oxford Road Tilehurst Reading Berks RG30 6TP Lead Inspector Julie Willis Unannounced Inspection 8th December 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service River View Care Centre Address Rodway Road, Off Oxford Road Tilehurst Reading Berks RG30 6TP 0118 9728360 018 972 8370 riverview@lifestylecare.co.uk 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) Life Style Care plc ***Post Vacant*** Care Home 137 Category(ies) of Dementia (20), Dementia - over 65 years of age registration, with number (81), Old age, not falling within any other of places category (56), Terminally ill (4) River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users not to be admitted under 60 years of age. Date of last inspection 18th June 2005 Brief Description of the Service: Riverview Care Centre provides nursing care to 137 users of both genders aged 65 years and over. The home has been purpose built to meet the needs of its users. The home is situated in the Tilehurst area of Reading and has accommodation on three floors. The home was first Registered in May 2004 for 61 people with dementia and 76 people who have needs associated with older age. River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 10.00 a.m. and 4.15 p.m. on a weekday morning and afternoon. The inspector visited all the occupied parts of the home, spoke to staff, residents and relatives and examined 9 care plans in detail, 5 staff files, financial and health & safety records. At the time of inspection there were 115 residents. The inspector spoke to 9 service users at length and others in small groups in various parts of the home. The inspector also spoke to 4 relatives that were visiting at the time of inspection. The inspector had received 2 complaints about the home since the last inspection both of which had been dealt with effectively by the Homes Manager and to the complainant’s satisfaction. There were no requirements outstanding from the previous inspection and only two requirements made as a result of this inspection. What the service does well: What has improved since the last inspection? River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 6 The Chef has met with nutritional experts for advice about special diets and is providing a nourishing, varied and tasty menu for the residents. Staff are being deployed more effectively in various parts of the home. Care plans are being completed more robustly following admission to ensure that staff know how to meet users needs. Fans and air conditioners are available for use in hot weather. 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. River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 All service users are comprehensively assessed prior to admission to ensure that the staff of the home will be able to fully meet their needs. EVIDENCE: The inspector examined admission records in various parts of the home. A cross section was taken of those users that were self-funding and those who were admitted via health and social services. It was evident that members of the management team had carried out a full assessment of the users needs prior to admission. Where appropriate a copy of the Care Management assessment and a copy of the care plan produced for care management purposes had been provided to the home pre-admission. The tool used for the purposes of assessment was holistic and comprehensive in detail and gathered sufficient information to ensure that the home would be able to effectively meet the users need. Information was gathered from a range of sources, including the user, their family and other health and social care professionals. River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 9 The information detailed in the pre-admission assessment was used to produce an initial care plan and to ensure that any aids or equipment needed by the user would be available on admission. Service users relatives confirmed that they had been involved with the users admission to the home and had been provided with the opportunity to visit the home informally and ask any questions of staff and management. One relative said that they have felt fully involved from the out-set as they were able to meet the manager prior to the users admission and to answer questions on behalf of their mother. They said that they had found this comforting at a difficult time. The relative said that since admission they visit frequently and have been kept up-to-date and fully involved in the users care. River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 Care plans were sufficiently detailed and up-to-date to enable staff to effectively meet the needs of users. EVIDENCE: A number of the care plans were sampled in each unit of the home and were found to be accurately documented, well recorded and up-to-date. The documentation encompassed service users personal, health care, activity plans, specialist needs and behaviour management guidelines in an easy to use format. Clinical tools were being used routinely to assess the risks associated with manual handling, nutrition, skin integrity and use of restraint devices such as cot sides. Where a risk was identified there were effective risk reduction measures in place. The inspector had the opportunity to discuss the admission process with a number of users and their relatives who confirmed that their individual needs were being met effectively by the home. Relative’s felt that they were being River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 11 kept informed about their relative and could have a say in how care was provided. River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14, 15 The home ensures that service users are provided with opportunities to express their personal choice and exercise control over their lives as much as possible. Meals at the home are nicely presented, tasty and nutritious. People requiring special diets can be catered for. EVIDENCE: From a tour of the building it was evident that service users are encouraged to personalise their own bedrooms in the home. Small furniture items may be accommodated and pictures and personal possessions are encouraged. The home promotes service users independence regarding personal finances although the majority of users do take advantage of the cash account system operated at the home. Small amounts of cash may be deposited with the administrator for items such as newspapers, hairdressing, chiropody and local purchases. Residents have the opportunity to participate in residents meetings. These follow a shared agenda and are chaired by the Activity Organisers at regular intervals. Minutes of meetings were examined and were observed to be entirely user focused. The meetings provide the users with an opportunity to River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 13 express their views and concerns and to have a say in the way the home is run. From discussion with the chef, examination of menus and food records and a tour of the kitchens it was evident that the catering staff have worked hard to improve the menus and provide users with more choice. Special diets can be provided and the chef frequently takes nutritional advice from experts in relation to special diets in order to provide the users with a more varied and nutritious menu. The kitchens were clean and hygienic and larders and freezers were well stocked. The budget for food has been reviewed and increased and the chef admits he is often over budget particularly with the run up to Christmas. The chef provides a ‘Chef’s special’ each Thursday in addition to the normal menu choices. The home is in the process of providing another chef in the kitchens in order to provide catering staff with the opportunity to participate in further developmental opportunities such as the advanced course in food hygiene. A recent visit from the Environmental Health Officers awarded the catering department a Silver Hygiene award. Service users and their relatives confirmed that the menu has been more varied of late and that the quality of the food had generally improved. A recent complaint made to the CSCI regarding the quality of the service users ‘low potassium diet’ has been resolved to the satisfaction of the complainant. This involved meeting with a nutritional expert and agreeing an appropriate menu. River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 There was a shortfall in abuse training for staff, which could pose a risk to users. EVIDENCE: There was evidence from examination of records, copies of Regulation 37 notifications and discussion with management that the home follows the interagency strategy on abuse of vulnerable adults. From examination of staff records it was evident that there was a shortfall in the number of staff that have received POVA training since starting work at the home. Records indicated that only 14 staff had received the training in the past year and this shortfall in training needs to be addressed as a matter of urgency in light of the most recent POVA incident. River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): This standard was not fully inspected on this occasion. EVIDENCE: This standard was not fully inspected on this occasion. River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Staff were clearly able to demonstrate that they have the necessary skills and experience to effectively meet the needs of service users in their care. Staff recruitment procedures are robust, transparent and protect service users from harm. Staffing levels are sufficient to meet the needs of users of the service. EVIDENCE: At the time of inspection there were sufficient care and nursing staff on duty in all parts of the home to meet the needs of users. The home has a full complement of permanent staff and has recently recruited several nurses who were previously working in local hospitals for the NHS. Advertisements have recently been placed locally for laundry, domestic and kitchen staff and is receiving a positive response with interviews planned in the near future for the vacant positions. From examination of the recruitment files for the 4 most recent care staff it was evident that all necessary checks are undertaken on employees to ensure the safety and protection of service users. The staff records were well documented and organised and the content of files met the required standard. There was evidence that the home routinely undertakes additional checks on all qualified nurses. Nurses are required to provide original copies of documents such as their passport, driver’s licence and birth certificate to prove River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 17 their identity. This enables the home to carry out a Criminal Records Bureau and POVA check to ensure that the nurses supplied are suitable to work with vulnerable adults. Additionally all nursing staff provide documentary evidence of their professional training, immunisation status and health record. Confirmation of nurse’s current registration status is made by the home via the Nursing and Midwifery Councils web site. The home also checks notifications from the NMC about nurses who have been removed or suspended from the register. New Registered Nurses are required to shadow a senior member of the nursing staff who will assess their competence in relation to various tasks including the administration of medication before they work independently. New staff are provided with induction and foundation training to Sector Skills Council standard and are offered opportunities to gain qualifications to further enhance their knowledge and skills such as National Vocational Qualifications at level 2 & 3. All staff are provided with refresher training at regular intervals, in core skills such as fire safety awareness, health & safety, first aid, manual handling and infection control to ensure service user safety. There is a need to ensure that all staff receive POVA training to protect users from abuse and exploitation. All staff receive on-going support and are formally supervised. Nurses receive clinical supervision. From discussion with staff, it was clear that those interviewed had a good understanding of how their individual role benefits the work of the team and a thorough knowledge of the key values that underpin their work with service users. Service users and their relatives were positive about the qualities and caring attitude of the staff. They told the inspector that staff appeared “kind and friendly” and “kept them informed of what was going on”. River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 The registered manager is qualified, competent and experienced to run the home for the benefit of residents. Service users benefit from living in a well managed home, where there is evidence that their health welfare and safety is of primary importance. The policies and procedures regarding service user finances safeguard the interests of residents. The absence of an effective quality assurance system means that there is only limited monitoring of outcomes for service users. EVIDENCE: The Homes Manager is a widely experienced qualified nurse who is currently undertaking an NVQ 4 in management of care to further enhance her knowledge and skills. The manager is well supported by two deputies and a River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 19 team of registered nurses. The current management structure appears to be sufficient to reflect the size and complexity of business currently undertaken but should be kept under review as the home increases to its maximum number of 137 residents. The Homes Manager has continued to demonstrate effective leadership skills over a difficult and unstable period and continues to improve the quality of care provided to users overall. Staff appear well motivated, cheerful and up beat about working at the home and confirm that they have the opportunity to express their opinions openly in staff meetings, supervision sessions and staff handovers. The recent introduction of the ‘morning professionals meeting’ has had a beneficial effect on the quality and continuity of care. Nurses feel that the atmosphere in the home is more inclusive and recognises and values their professional expertise and experience. Staff say that they are provided with opportunities to express concerns, share information and to feel included and involved in the way the service is delivered. There is a need for the home to implement a quality assurance system, which is based on seeking the views of users. This could help the management to measure their success in meeting the aims and objectives of the home. The inspector had the opportunity to discuss the procedure for administering resident’s cash accounts with the homes administrator. It would seem that the majority (85 ) of users take advantage of this method of managing their personal finances and paying local bills. The system seems open, transparent and fair. Service users receive interest on any monies held on their behalf and a foolproof system is in operation for the safe deposit or withdrawal of resident’s monies. Receipts are kept of all cash spent. Most service users have family members that deal with their financial affairs and only small amounts are deposited with the home. The majority of the money is held in separate accounts at head office. Examination of health & safety records indicated that they were up to date and in good order. Routine servicing and maintenance of equipment is undertaken at appropriate intervals to maintain the home as a safe and risk free environment for users. All risks to users are effectively risk assessed and managed. River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 2 x x x x x x x x STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 3 River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? NO 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 2 Standard OP18 OP33 Regulation 13 (6) 24 Requirement Ensure that all staff receive POVA refresher training Ensure that a quality assurance system is implemented which seeks the views of users of the service Timescale for action 08/03/06 08/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 River View Care Centre DS0000060077.V263842.R01.S.doc Version 5.0 Page 23 - 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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