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Inspection on 23/05/05 for River View Day Care & Respite Centre

Also see our care home review for River View Day Care & Respite Centre for more information

This inspection was carried out on 23rd May 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Riverview provides a homely and comfortable place to stay. The accommodation is for a maximum of six people, and so is well suited to people with dementia. There is a good level of staffing and Service Users thought that the standard of care was very good. Service Users are offered a wide range of activities, in small groups. Service Users said that the food was very good, that there was plenty of it, and well cooked.

What has improved since the last inspection?

A high quality service has continued to be provided. Covers have now been fitted to all radiators, to avoid Service Users being injured. The temperature of hot water is now being monitored, to avoid Service Users being inadvertently scaled.

What the care home could do better:

Improvements have been required in relation to fire safety, fire doors were found to have been wedged open. Requirements have also been made for the Registered Providers to improve staff recruitment, so that Service Users can be confident that they will be well cared for.

CARE HOMES FOR OLDER PEOPLE River View Day Care/Respite Centre Astor Drive Mount Gould Plymouth PL4 9RD Lead Inspector Helen Tworkowski Announced 23 May 2005 rd 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 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 D52-D04 S3455 Riverview V221644 230505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service River View Day Care/Respite Centre Address Astor Drive, Mount Gould, Plymouth, Devon, PL4 9RD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01752 253974 01752 251618 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 D52-D04 S3455 Riverview V221644 230505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Respite only 2. Age 50yrs Date of last inspection 13/12/04 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 D52-D04 S3455 Riverview V221644 230505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Announced Inspection took place on Monday 23 May 05, between 9am and 5.30pm. Time was spent with the Manager and Service Users, and feedback was received from relatives of Service Users. Records and files were looked at, and a partial tour of the building was made. What the service does well: 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. River View Day Care/Respite Centre D52-D04 S3455 Riverview V221644 230505 Stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection River View Day Care/Respite Centre D52-D04 S3455 Riverview V221644 230505 Stage 4.doc Version 1.30 Page 7 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 standard(s) 2, 3 and 5 The thorough system that assesses the needs of prospective service users, ensures Riverview is able to met peoples needs. EVIDENCE: Before a person comes to stay at Riverview an assessment will have been completed. For many people this will have been initially done by Social Services. Staff from Riverview also go to meet the Service User and their relatives and complete their own assessment. This provides very detailed information about an individual’s preferences and how they wish to be cared for during their stay. Service Users whose stay at the home is arranged by Social Services are not given an terms or conditions for their stay, though other people do receive a contract. It is important that everyone staying at Riverview knows what they can expect, including what will be provided and what they must fund themselves. River View Day Care/Respite Centre D52-D04 S3455 Riverview V221644 230505 Stage 4.doc Version 1.30 Page 8 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 standard(s) 7,8,9 and 10 The home has a good system to provide information about how each person’s individual needs will be met. Some improvements are recommended in the way risks are managed and mitigated, ensuring that people are kept safe. EVIDENCE: Each person has a Service User Plan, the documents seen were brief but to the point. Service User Plans explain in detail the actions staff are to take to meet the needs of the individual. There are risk assessments, which contain information about how individuals will be kept safe, however these documents are rather confusing dealing with a number of different risks at the same time. It is recommended that this system is reviewed and each risk is considered in it’s own right. Service Users spoken with said they were treated with dignity and respect by staff, and this was observed during the inspection. Staff knocked on bedroom doors before they entered. River View Day Care/Respite Centre D52-D04 S3455 Riverview V221644 230505 Stage 4.doc Version 1.30 Page 9 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 standard(s) 12,13,14,15 Service Users are provided with a very good range of activities and are able to maintain their independence as far as possible. Meals are well cooked and plenty of choice is provided. EVIDENCE: Service Users staying at the Riverview respite service are encouraged to take part in activities provided by the “day care service”. Activities are provided in small groups- often of five or six. A range of activities are 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 contacted 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 is eaten in the dining room of the respite accommodation. Whilst there is a set River View Day Care/Respite Centre D52-D04 S3455 Riverview V221644 230505 Stage 4.doc Version 1.30 Page 10 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. River View Day Care/Respite Centre D52-D04 S3455 Riverview V221644 230505 Stage 4.doc Version 1.30 Page 11 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 standard(s) None of these standards were inspected during this visit. EVIDENCE: River View Day Care/Respite Centre D52-D04 S3455 Riverview V221644 230505 Stage 4.doc Version 1.30 Page 12 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 standard(s) 19, 20 and 26. The respite accommodation at Riverview is clean, tidy and well maintained. EVIDENCE: Riverview can accommodate six people, there are four single bedrooms and one double rooms. There is a lounge/diner and a kitchen. Not all of the bedrooms were seen, however the areas seen were clean and homely. The size of Riverview means that it easy for people to find their way around and to feel at home. River View Day Care/Respite Centre D52-D04 S3455 Riverview V221644 230505 Stage 4.doc Version 1.30 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 A good level of staffing is provided however the recruitment system for staff is in need of improvement, so that it better protects service users. Some staff do not receive induction training for several months, which means that staff may not be initially competent to support service users. EVIDENCE: Staff work between Riverview Day Service and respite care, this means that people staying overnight will often be familiar with staff through meeting them in the day centre. There are 2 care staff on duty to support people staying in the respite care service, including 2 waking night staff. This is a good level of support for the people using the service. Prospective staff are interviewed however references are not always taken prior to a member of staff starting work, this could potentially place Service Users at risk. There are systems for the induction of new staff, however staff do not receive a formal induction until they have been in post some months. As staff are required to provide care during this initial period, staff need to be inducted to provide this care. River View Day Care/Respite Centre D52-D04 S3455 Riverview V221644 230505 Stage 4.doc Version 1.30 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 38 The home is run in the interest of the people who stay at Riverview, Service Users and their relatives are consulted and involved in the running of the home. The home is well maintained however improvements are required to the fire safety system, including ensuring that fire doors are not wedged. EVIDENCE: Regular meetings are held with people who use Riverview and their relatives. The home carries out regular fire checks, however monthly checks of emergency lighting and extinguishers have not been done. A number of fire doors were wedged open on the ground and second floor, and a immediate requirement was made that such doors should not be wedged. Checks are made of the hot water in bathrooms, to ensure that Service Users are not scalded. River View Day Care/Respite Centre D52-D04 S3455 Riverview V221644 230505 Stage 4.doc Version 1.30 Page 15 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 2 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 3 x x x x 1 River View Day Care/Respite Centre D52-D04 S3455 Riverview V221644 230505 Stage 4.doc Version 1.30 Page 16 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. 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 all new staff should be competent and fit to work in the home, this process of establishing fitness must include taking two written references and a CRB check must have been initiated. All new staff must be inducted in their work from the point they start work in the home. This induction process must be recorded. Immediate Requirement: Fire doors must not be wedged open. Timescale for action 1/7/05 2. OP2 12 1/8/05 3. OP29 19 1/8/05 4. OP30 18 1/8/05 5. OP38 13,23 23/5/05 River View Day Care/Respite Centre D52-D04 S3455 Riverview V221644 230505 Stage 4.doc Version 1.30 Page 17 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 OP7 Good Practice Recommendations The system for risk assessing individual service users, and keeping them safe, is reviewed. River View Day Care/Respite Centre D52-D04 S3455 Riverview V221644 230505 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection 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 D52-D04 S3455 Riverview V221644 230505 Stage 4.doc Version 1.30 Page 19 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!