CARE HOMES FOR OLDER PEOPLE
Riverhead Hall Nursing Home Limited Riverhead Driffield East Yorkshire YO25 6NU Lead Inspector
Mrs Rosalind Sanderson Unannounced Inspection 9th January 2006 09:30 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 Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 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. Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Riverhead Hall Nursing Home Limited Address Riverhead Driffield East Yorkshire YO25 6NU 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) 01377 253863 01377 257665 Riverhead Hall Nursing Home Limited Mrs Diana Elizabeth Robinson Care Home 34 Category(ies) of Dementia - over 65 years of age (34), Old age, registration, with number not falling within any other category (34), of places Physical disability over 65 years of age (34), Terminally ill over 65 years of age (34) Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 13th September 2005 Brief Description of the Service: Riverhead Hall is registered to provide nursing care and accommodation for up to 34 people. The registration allows the home to admit older people who require nursing care who have a disability, who are terminally ill, or who suffer from a dementia. The home is situated in beautiful grounds on the outskirts of the market town of Driffield. There are parking facilities within the grounds. The home provides two lounges, a dining room and a conservatory. There is also a patio area overlooking the garden. Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over one day and lasted for five hours with two hours preparation having taken place prior to the inspection. The registered provider, Mrs Jean Jordan, and the registered manager, Mrs Diana Robinson, were available to assist during the inspection. The inspection process involved speaking with service users and staff, looking at staff records and health and safety records. Service users communal and private areas were looked at with their permission. The atmosphere within the home was warm and welcoming and all of the service users looked happy and content. What the service does well:
Service users enjoy living at Riverhead. They feel they have control over their lives and that they are listened to and valued. Comments received include, ‘I’ve always had a drink of beer before lunch and since coming here I’ve continued to do this’ ‘I have my own telephone so that I can keep in touch with my sister who lives away and talk with her when I wish.’ The service users like the staff and feel they are treated well with all their needs being met, ‘‘The staff always knock before they come into my room and always, without fail, give the care to me that I need and that I ask for’. The grounds of the home are lovely and well maintained, service users commented, ‘‘I don’t get out much but am able to look at the lovely garden and enjoy watching the birds’ Similarly the home is decorated to a high standard that is appreciated by service users. One said, ‘My room is lovely and decorated exactly how I would have if at home. I have brought in my own furniture and so it definitely is the next best thing to home’ Service users are able to choose how they spend their days and again commented, ‘‘There are plenty of things going on in the home but I choose to stay in my room most of the time’ Service user views are sought to inform the manager of how things may be improved. One said, ‘We are always asked about what could be done to make things better for us. Its hard to think of anything but its nice to be asked’. Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 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. Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 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 Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 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): These standards were not assessed at this inspection. EVIDENCE: Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 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): These standards were not assessed at this inspection. EVIDENCE: Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 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): 12,13,14 Service users are able to exercise choice and flexibility in their daily lives. EVIDENCE: Service users said they liked living at Riverhead. They feel they have control over their day-to-day lives. One commented, ‘There are plenty of things going on in the home but I choose to stay in my room most of the time’ and ‘I’ve always had a drink of beer before lunch and since coming here I’ve continued to do this’ Another said, ‘The staff always knock before they come into my room and always, without fail, give the care to me that I need and that I ask for’. There is an open visiting policy so that relatives can visit to suit them and the service user. One lady said ‘I have my own telephone so that I can keep in touch with my sister who lives away and talk with her when I wish.’ Service users have recently enjoyed the Christmas party held at the home and planting up hyacinth bulbs to give as gifts or to enjoy theirselves. Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 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 the following standard(s): 16,18 Service users are protected and any concerns they have are listened to. EVIDENCE: Since the last inspection staff have received training in adult protection to ensure they are all aware of what action to take if an incident occurred. Staff spoken with were clear about what their actions would be in the event of a disclosure being made or an incident witnessed. The complaints procedure is available to all service users in their rooms and it is also displayed in the hall so that visitors may see it and be aware of what to do if they had a complaint. Service users said, ‘I complain quite a lot really!! The problems are usually not that serious. They always listen, no matter how small the complaint.’ Another said, ‘I have had reason to complain and it was sorted out very quickly and to my satisfaction, I am very confident about the whole procedure’ Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 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 the following standard(s): 19 Service users live in a home that is safe and well maintained EVIDENCE: The home is situated in its own grounds and service users benefit from the lovely, well maintained gardens. One service user said, ‘I don’t go out in the winter but really look forward to spending time in the garden during the warm weather’. Another said, ‘I don’t get out much but am able to look at the lovely garden and enjoy watching the birds’ The home is well decorated and there are no unpleasant odours. A service user commented, ‘My room is lovely and decorated exactly how I would have if at home. I have brought in my own furniture and so it definitely is the next best thing to home’ The home complies with the local fire authority and environmental health office. There had been no requirements from their last visits.
Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 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 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): 28,29 Staff that are trained to do so care for service users, however, recruitment practices at the home have the potential to place these service users at unnecessary risk. EVIDENCE: Staff are well informed about each service users needs and were observed speaking kindly and patiently to them whilst encouraging their independence. The staff have received training in all mandatory areas and also in other areas relevant to this service user group. At the present time 45.5 of care staff hold the NVQ qualification in care with a further three staff working towards this award. Recruitment records showed that staff had been deployed at the home without the pre employment checks in place. In two instances a CRB had not been obtained and no confirmation received that they were not entered on the P.O.V.A. register. In another case only one reference had been obtained. Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 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 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 home is well managed and to ensure that this continues the requirements made in this report must be addressed. EVIDENCE: The manager and her deputy are experienced nurses. The manager holds a BSc in Health and Social Care that includes management and the deputy holds the Registered Managers Award. A quality assurance system that is in place informs the manager how the home is performing and is used to develop the annual development plan. Service user feel that their views are taken into account and one comment made was, ‘We are always asked about what could be done to make things better for us. Its hard to think of anything but its nice to be asked’. Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 Page 15 Service users are encouraged to handle their own finances but the manager hold some personal monies for some. These are stored securely and safely and records and receipts are kept of all transactions in order to account for these. All certificates relating to health and safety were seen and were current. The fire safety checks were inspected and found to have some omissions in the weekly checks of fire alarms and emergency lighting. Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 Page 16 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X X STAFFING Standard No Score 27 X 28 3 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 1 Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 Page 17 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. Standard OP29 Regulation 19(1(b(i)) Requirement The registered person must ensure that prior to deployment of staff they have obtained: • Two satisfactory written references relating to the applicant. • A CRB check relating to the applicant. • Where a P.O.V.A. 1st has been applied for the registered person must await confirmation that this is clear before the staff member is deployed and ensure that the person works under supervision until a full CRB is received. The registered manager must ensure that the weekly checks of fire alarms and emergency lighting is carried out weekly Timescale for action 09/01/06 2. OP38 23(4(v)) 30/01/06 Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 Page 18 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 Riverhead Hall Nursing Home Limited DS0000000948.V275427.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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