Inspection on 22/02/06 for River View Day Care & Respite Centre

This inspection was carried out on 22nd February 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

River View Day Care & Respite... 24/03/09

River View Day Care & Respite... 07/01/07

River View Day Care & Respite... 23/05/05

River View Day Care & Respite... 13/12/04

River View Day Care & Respite... 20/07/04

River View Day Care & Respite... 05/03/04

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

CARE HOMES FOR OLDER PEOPLE River View Day Care/Respite Centre Astor Drive Mount Gould Plymouth Devon PL4 9RD Lead Inspector Sheila Giblin Unannounced Inspection 22nd February 2006 09:15 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 Day Care/Respite Centre DS0000003455.V258912.R03.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 Day Care/Respite Centre DS0000003455.V258912.R03.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service River View Day Care/Respite Centre Address Astor Drive Mount Gould Plymouth Devon PL4 9RD 01752 253974 01752 251618 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) Plymouth Age Concern Mrs Denise Margaret Gregson Care Home 6 Category(ies) of Dementia (6), Dementia - over 65 years of age registration, with number (6) of places River View Day Care/Respite Centre DS0000003455.V258912.R03.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Respite only Age 50yrs Date of last inspection Brief Description of the Service: Plymouth Age Concern runs Riverview, providing day and respite care for older people who require this service due to dementia. Riverview as the name suggests has uninterrupted views over the Plym River proving an interest for the Service Users. The Social Services Department has referred the majority of Service Users to the Centre. The building is located next to The William and Patricia Venton Centre, also an Age Concern establishment. The day centre occupies the ground floor, the respite residential unit occupies the first floor and the administrative centre occupies the second floor. Those Service Users resident in the respite unit are invited to attend the activities organised in the day centre. River View Day Care/Respite Centre DS0000003455.V258912.R03.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the morning of Wednesday 22nd February 2006. The registered manager Ms Gregson, was present for part of the inspection and the assistant manager provided additional information and guidance. There were three respite care service users in residence: all were seen in the day care unit with other day care service users. The inspector toured the accommodation, met staff and viewed records and documents. Lunch was taken with the service users. What the service does well: What has improved since the last inspection? What they could do better: Terms and Conditions of services to be provided should be signed and a copy held on file. Care Plans and risk assessments must be updated and reviewed at every admission. Tests and checks to the emergency lighting and the fire extinguishers have still not been completed monthly as previously required. Records of any service users’ cash or valuables held for safekeeping must be reviewed to ensure residents are protected from any risk of financial abuse. Procedures to cover specific personal health and care needs must be written for staff to follow to ensure best practice is observed and to avoid cross infection. River View Day Care/Respite Centre DS0000003455.V258912.R03.S.doc Version 5.0 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. River View Day Care/Respite Centre DS0000003455.V258912.R03.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 Day Care/Respite Centre DS0000003455.V258912.R03.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): 2, 3, 6 Prospective service users and their relatives can be confident they will be given sufficient information to enable them to make a choice about whether to use these services. EVIDENCE: Terms and Conditions have been written but have not been given to all the residents or their relatives to ensure they know what to expect from the respite care services. Service users have been assessed when first using the services but these have not always been updated when they are readmitted. The centre does not provide intermediate care. The usual period spent in the unit would not exceed one month. River View Day Care/Respite Centre DS0000003455.V258912.R03.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 10 Service users cannot be confident that staff have up to date information in order to be able to fully meet their needs. EVIDENCE: Three care plans and risk assessments were seen in service users’ personal files. Two service users have used the respite care service regularly throughout previous years. Their care plans and risk assessments have not been updated at each admission to ensure care is provided in keeping with their current needs and medical conditions. Two residents had specific health care needs requiring staff to have knowledge and skills to manage these properly. There were no written procedures to inform staff about essential techniques to prevent cross infection and to ensure staff are aware of what action to take in an emergency. During the inspection, staff were heard discussing the personal care needs of service users in the day centre lounge and confidential information was shared which could have been overheard by other service users present. River View Day Care/Respite Centre DS0000003455.V258912.R03.S.doc Version 5.0 Page 10 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): 12, 14, 15 Service users can be sure of receiving respite care in a friendly caring atmosphere. EVIDENCE: Service Users staying at the Riverview respite service are encouraged to take part in activities provided by the “day care service” rather than remain in the respite care unit on the first floor. The inspector was assured that should a service user express a wish to remain in their room, this would be respected. Activities were provided in a large group, although there was an alternative craft activity offered but declined. A range of activities may be provided at any one time- such as a trip out, crafts, quizzes or watching a film. Service Users also have the option of opting out and simply enjoying the view over the river. All Service Users who use the Riverview live in the community, and visit Riverview for respite care and support; this may mean that during the stay there is limited contact with relatives. Service Users are encouraged to maintain the same level of independence and choice they have at home. Including preparing drinks and snacks, handling money and having a role in managing their medication. Main meals are cooked in the adjacent building and transported to Riverview in a heated trolley. People staying in the respite service generally eat their lunch in the day care service. A choice of meals is offered. Breakfast, tea and supper River View Day Care/Respite Centre DS0000003455.V258912.R03.S.doc Version 5.0 Page 11 is eaten in the dining room of the respite accommodation. Whilst there is a set menu, individuals are able to make their own snacks and to choose what they would eat, as they would at home. There is limited dining space in the respite accommodation, however it is comfortable and homely. The three course meal served on the day of this inspection was of a very high standard. Service users said how much they had enjoyed the meal. River View Day Care/Respite Centre DS0000003455.V258912.R03.S.doc Version 5.0 Page 12 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): 16, 18 Service users and their relatives can be confident that any complaints they might have will be taken seriously and their concerns listened to. EVIDENCE: Ms Gregson told the inspector that there have been no complaints made at River View. The complaints/ compliments book was not available for inspection. Service users seen said they had not had cause for complaint and were very satisfied with the services they received. All bar three of the fifteen staff members have attended a course on the Protection of Vulnerable Adults. River View Day Care/Respite Centre DS0000003455.V258912.R03.S.doc Version 5.0 Page 13 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): 19, 21, 23, 24, 25, 26 Service users are assured of a clean, comfortable and attractive place to spend a short period of respite care. EVIDENCE: The respite care unit at River View is on the first floor of a three storey building. There are four single bedrooms and one double. There are two bathrooms/toilets. Day centre clients other than those receiving respite care are assisted to bath in the bathrooms. There was a kitchen and a lounge/diner. All were well furnished and attractively decorated. Being a short-term respite care unit, service users had not brought a lot of personal possessions into their rooms. The unit was clean and fresh smelling and tidy throughout. The paintwork on the tubular frame on a commode chair in one bedroom was worn and unsightly. The paintwork on the wall around one of the hand basins was flaking and therefore unhygienic as the wall could not be cleaned effectively. The inspector was informed that the room was awaiting redecoration. The window catches on two bedroom windows were broken and neither could be secured properly. Being a cold winters day there was a chilly draught River View Day Care/Respite Centre DS0000003455.V258912.R03.S.doc Version 5.0 Page 14 coming through into the room. The assistant manager said repairs had been requested but not yet carried out. Interlinking doors in the corridors in the day centre on the ground floor have double handles to minimise the risk of confused residents leaving the home unnoticed. The Registered Manager asked about the availability of suitable alternatives that would be equally effective. External doors have alarms to alert staff when someone is entering or leaving the building. River View Day Care/Respite Centre DS0000003455.V258912.R03.S.doc Version 5.0 Page 15 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): 29, 30 Service users coming into River View can be confident that the staff team have been recruited to provide a high standard of support and care. EVIDENCE: There are fifteen staff employed to provide care and support to the people who attend the day centre and those who are admitted to the respite care unit. During the inspection staff on duty were observed working closely with day care clients and respite care service users. They were friendly and helpful, kind and attentive. The personal files were seen of the last three staff employed. These are held confidentially in the Human Resources department on the third floor of the same building. All the records required to be kept on staff files were seen, including proof of identity, two references, Criminal Records Bureau disclosures, qualifications certificates and a photograph. Since the previous inspection the Registered Manager has introduced an initial induction process for new starters. Age Concern employs a high number of people in its centres and care homes. A formal induction course is organised every three months and new staff are expected to attend during their three month probationary period. River View Day Care/Respite Centre DS0000003455.V258912.R03.S.doc Version 5.0 Page 16 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): 32, 35, 38 Service Users benefit from being in a well run unit. EVIDENCE: The atmosphere in the unit was bright and cheerful. Service users were welcomed with a cup of tea or coffee. Service users said how much they enjoyed coming to the centre. Being a respite care unit means that people coming in for short term care very rarely need assistance with their cash. However, some do bring small and occasionally, large sums of money which is handed in to the office for safe keeping. The systems and records for this process are insufficient to ensure that monies are handled correctly and securely to safeguard service users’ best interests, especially as they have varying degrees of dementia and may not be able to recall the details accurately. Fire detection and prevention systems have been tested and checked by appropriate contractors. However, monthly checks for lighting systems and the fire extinguishers have not been conducted or recorded by the unit’s staff. River View Day Care/Respite Centre DS0000003455.V258912.R03.S.doc Version 5.0 Page 17 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 2 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 X 3 3 3 3 STAFFING Standard No Score 27 X 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X X 2 X X 2 River View Day Care/Respite Centre DS0000003455.V258912.R03.S.doc Version 5.0 Page 18 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 OP38 Regulation 23 Requirement Monthly checks of the emergency lighting and extinguishers must be made and recorded. (This requirement was made at the last inspection and has not been met.) All Service Users must be given a copy of the terms and conditions of their stay at Riverview. The registered person must ensure that service users are reassessed each time they are admitted to the respite care unit Care plans must be reviewed and updated each time a service user is admitted for respite care.. Service users’ personal and confidential information must not be discussed in the communal areas within earshot of others. 1. Broken window handles must be repaired in the two bedrooms identified. 2. The paintwork/plaster around the hand basin in bedroom 4 must be repaired 3. The old worn commode DS0000003455.V258912.R03.S.doc Timescale for action 01/05/06 2. OP2 12 01/08/06 3. OP3 14 01/08/06 4. 5. OP7 OP10 15 12 01/08/06 23/05/06 6 OP19 23 15/03/06 River View Day Care/Respite Centre Version 5.0 Page 19 7 OP35 Schedule 4: 17(2) must be replaced as discussed and agreed. The system for recording any 01/04/06 service users’ monies and valuables being held for safekeeping must be reviewed to ensure their security. 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 Day Care/Respite Centre DS0000003455.V258912.R03.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Day Care/Respite Centre DS0000003455.V258912.R03.S.doc Version 5.0 Page 21 - 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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