Inspection on 03/08/05 for Riverlea House

This inspection was carried out on 3rd August 2005.

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

Riverlea House 20/06/07

Riverlea House 27/06/06

Riverlea House 20/04/05

Riverlea House 19/01/05

Riverlea House 02/09/04

Riverlea House 06/02/04

Riverlea House 13/11/03

Similar services:

Springfield House

The Shelley

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Riverlea House 105b/107 Lower Road, River, Dover Kent CT17 0QY Lead Inspector June Davies Announced 03/08/05 at 10:00am 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. Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Riverlea House Address 105b/107 Lower Road, River, Dover, Kent CT17 0QY 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) 01304 823935 Choicecare 2000 Limited Registered Care Home 44 Category(ies) of Old Age registration, with number of places Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20/04/05 Brief Description of the Service: Riverlea is a large detached 44 bedded care home for the elderly, situated in the village of River, on the outskirts of the town of Dover. The home is situated close to village shops and public houses, and public transport is easily accessible. The home is situated on two floors, and there is a passenger lift giving access to the first floor. On the ground floor there are four pleasant communal lounges, a dining room and dining area. The grounds of the home are small, with two patio areas, and two lawned areas that back onto the river. There is a small parking area at the front of the property and to the rear of the property. Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and took place over two days and in all accounted for 15 hours. Four visits have also been made to Riverlea House since the last inspection. The CSCI, Pharmacy Inspector carried out an inspection of the medication practices in the home, during the course of two visits and the announced inspection, and this resulted in two immediate requirement letters being placed on Riverlea House. Two visits were made to the home by the lead regulatory inspector to investigate complaints made to CSCI in regard to lack of staffing and bad care practices being carried out at the home, this resulted in immediate requirement letters to ensure that the staffing levels in the home were raised to meet the assessed needs of the residents in the home. During all visits and the announced inspection the inspector, gained information from observation, talking to residents and staff, and inspecting documents. What the service does well: What has improved since the last inspection? What they could do better: Every aspect regarding, staff training, ordering, recording, administration, storage, and disposal of medication in the home is causing concern, resulting in immediate requirements being placed, to ensure that medication is handled in such a way to meet the requirements of the Royal Pharmaceutical Society. Observation has shown bad care practices in the home and requirements have been made in respect of induction, staff training and supervision and an even skill mix of staff. If requirements in regards to medication and staff practice is not met enforcement action will take place. Residents care plans were seen to be lacking in vital information, and it was impossible to track visits by health care professionals, and what the outcomes of these visits were, information in regard to personal care is not being documented therefore, requirements have been made for pre-admission assessments to be fully completed, care plans to Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 6 be written clearly and in detail to include all aspects of personal care, and for care plans to be reviewed on a monthly basis, and where a change in care is required this needs to be clearly written. Residents stated that they were not always given choice, and that sometime the food presented by the home was not too good, and a requirement has been made in regard to residents being offered a varied, appealing and nutritious diet, which is suited to assessed needs of the residents. Many of the residents in the home were not aware of the complaints procedure, and there was no evidence of the complaints procedure being displayed in the home, and a requirement has been made that residents and visitors are made aware of the complaints policy and procedure. Requirements have been made within this report for the maintenance of hygiene, the control of the risk of spreading infection, at the present time infection control in some areas of the home is not being adhered to, and it was also noted that in some areas of the home there were offensive odours. Other requirements made were for the grounds of the home to be kept tidy, safe and attractive, for one ground floor communal toilet to be well maintained , and for hand rails to be fitted in communal hallways in line with the occupational therapy report. 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. Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 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 standard(s) 1, 2, 3, 4. The homes service user guide is inadequate and does not provide sufficient information for prospective residents to be sure the home can meet their needs. Contracts/statements of terms and conditions do not provide sufficient information for the residents. The pre-admission assessments for prospective residents do not contain sufficient information to give the staff a clear picture of the prospective residents needs. Staff do not demonstrate basic care skills to ensure they can meet the individual needs of all the residents in the home. EVIDENCE: The inspector viewed both the statement of purpose and the service user guide. Residents spoken to during the course of the inspection said they were not aware of these documents, but the inspector noted that both documents were available in the entrance hall of the home. A requirement has been made that the service user guide is reviewed and contains the required information. While the inspector witnessed that the home does have contracts or statements of terms and conditions for the residents in the home, those viewed had not been completed, some lacked the fees payable, one contract had not been completed at all, and another had not been signed by the resident, therefore a requirement has been made to ensure that all contracts, Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 9 statements of terms and conditions are fully completed and signed by the The inspector viewed pre-admission resident or his/her representative. assessments and while in some cases the homes pre-admission assessment was comprehensive, those pre-admission assessments carried out by the care manager lacked information, in regard to mobility of the resident, medication that the resident was taking, and aids that the resident may need to use. A requirement has been made that in future the manager of the home ensures that care managers pre-admission assessments are complete and give enough information in regard to the proposed resident. During the course of the visit the inspector witnessed bad care practices being carried out and has also made a requirement in regard to skills and practices of staff. Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, 10. The care planning system is not clear and consistent to provide staff with the information they need to meet the residents’ needs. There is no consistent or detailed recording of staff and other external professionals meeting the health needs of the residents. Personal care is offered in a way to protect the residents’ privacy. The home has failed to improve medication practices and their procedures for administering medication is placing residents at risk. EVIDENCE: The inspector was able to view three care plans in detail, and found that these care plans did not accurately reflect or track the care needs of the residents. One visitor spoken to during the visit, was aware that she could view her mother’s care plan, but had not done so, and admitted that she was not sure if the care plan accurately reflected her mother’s needs. The inspector has made a requirement that care plans are clearly written and reflect in detail both the physical and social care needs of the residents in the home. Another requirement has been made for the home to ensure that all care plans are reviewed monthly and are appropriately updated, with clear descriptions as to what any change would entail. There was no accurate evidence available to show that staff regularly maintain, the personal care of the residents e.g. hair washing, nail care, checking tissue viability, bathing, oral care or carry out Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 11 regular nutritional screening. The inspector was also able to witness areas where the personal care of the residents could be improved on, this was especially true of two residents sitting in a lounge area, who were in need of personal attention. There was evidence around the home that some residents are supplied with pressure relieving equipment in the form of specialised mattresses and cushions. Evidence was available in the home to show that residents when required, are supplied with continence aids, but there was no evidence in daily records or the care plans to show that those residents requiring assistance with continence had been assessed or regularly reviewed by the continence nurse. The lack of evidence was also true of other medical professionals who might visit the residents. Where general practitioner visits had been recorded this is not followed up with accurate recording on the daily report records. Verbally the inspector was told that a CPN visits one resident and that there are regular visits from the chiropodist. Three residents said that they see the chiropodist every six weeks. On the first day of the inspector’s visit, some residents were taking part in gentle armchair exercises. The inspector has made requirements in regard to the home meeting the health care needs of the residents. During the course of this visit the pharmacy inspector also carried out a medication inspection, and this highlighted several areas of bad practice, both in the ordering, recording, handling, administration and disposal of medication, there was also evidence of poor practice, lack of training and absence of clear, comprehensive policies, poor practice was also evidenced by the inspector during the lunch time medication round. Therefore the inspector has made a requirement for the home to look at all its medication procedures. The inspector did witness during the inspection that staff were respecting the privacy of the residents, and were knocking on toilet and bedroom doors before entering. While visiting residents in the bedrooms the inspector witnessed that some of these residents had their own private phone. Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14, 15 Residents in the home have the opportunity to be involved in a variety of activities, and have access to the local community as and when they wish. Some residents are able to maintain choice and control over their lives, but this needs to be extended to all who live in the home. The meals in the home are variable, and more attention needs to be paid to those residents, who are less able than others, as to how their food is presented to them. EVIDENCE: The inspector spoke to five residents who all stated that they enjoyed the activities provided by the home, and that the activities co-ordinator was very kind to them. Three residents told the inspector that they had no wish to participate in the activities arranged by the home. An activities programme is in place in the home, and a copy of this was given to the inspector. On the two days that the inspector was visiting, the activities programme was being adhered to. The inspector also witnessed that a garden party was held on the second afternoon of the visit. The local church visits the home once a month to give communion to those residents who wish to take part. Some of the residents in the home are able to visit the local village shop. Three residents were able to visit the local park recently, and also visited the local pub to have lunch. Relatives often take residents out for car rides. There are no restrictions on visiting in the home. Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 13 The inspector spoke to ten residents in total, they all stated that they were Twenty-two given choices in respect of activities, going out of the home. residents in the home have requested that their personal allowances are kept in the safe in the office, and the inspector viewed the accounts procedure to ensure that residents’ monies are appropriately accounted for. All monies kept on residents behalf is audited on a monthly basis by a manager and the administrator employed by the home. The inspector witnessed that all monies are appropriately recorded, that receipts are kept. During a tour of the building and bedrooms the inspector witnessed that residents are able to bring personal possessions into the home with them. Many of the residents spoken to during the course of the visit stated that food was good some days and not so good on others, one resident who is partially sighted frequently does not know what she is eating, and staff do not explain this to her. One visitor said that some of the resident’s need help in cutting up their meat, especially when it is something like chops or a roast dinner. Some residents stated that they were given choices at meal times, four residents said that they were not given choice or could not remember being given a choice. On the two days of the visit, the inspector was able to witness food served at lunch time, and this appeared to be wholesome and nutritious, and there was evidence that some of the residents had a different meal to that on the main menu. Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 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 standard(s) 16, 18 The complaints process in the home is very poor with no complaints information available to the residents and no evidence that the residents views are listened to or acted upon. Arrangements for protecting residents are not satisfactory placing them at possible risk of abuse. EVIDENCE: The complaints policy and procedure was not evident in the home at the time of the visit. During discussion with a visitor to the home the inspector was told that, the visitor would speak with the manager, but should the complaint not be investigated appropriately they would not know how to take it further. The inspector was able to view the complaints book, which showed that three complaints had been made to the home since the last inspection, and written evidence was available to show that these complaints had been investigated fully, and outcomes had been sent to the complainant. Three residents told the inspector that they were not aware of the complaints policy and procedure, two said that if they needed to make a complaint they would speak to a member of staff and one resident said they would take their complaint to the manager. The inspector has made a requirement that residents are made aware of the complaints policy and procedure. Staff were not completely sure of the categories of adult abuse, but evidence was available to show that POVA training had been organised for staff on the The inspector spoke to three members of staff who 21st September 2005. stated that they were aware of the whistle blowing policy and procedure. The home does have policies and procedures for dealing with adult protection and abuse, but there was no evidence that these had recently been reviewed. The Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 15 inspector has made a recommendation that all policies and procedures should be reviewed on a regular basis. Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 16 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, 21, 22, 23, 24, 25, 26. Improvements to the environment will enhance the residents’ quality of life. The standard of hygiene in some parts of the home need to be improved upon to provide a safe, comfortable environment for the residents. EVIDENCE: Riverlea House is suitable for its stated purpose, and at the time of the inspector’s visit the entrance hall, and ground floor hallways were in the process of being decorated, and it is planned that new carpet will be fitted once decoration is complete. The inspector noted that pathways, and an area outside the laundry room were in need of sweeping, and dead leaves and rubbish removing, in a back garden area there were several delivery boxes stacked against the wall of the building, which could be a potential danger to any resident wandering around this garden area. A requirement has been made by the inspector to ensure that all outside areas are kept tidy, safe and attractive for the residents. The home has sufficient communal areas to meet the needs of the residents. All communal rooms are situated on the ground Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 17 floor and consist of one dining room, a diner/lounge, and four lounge areas. All communal areas have domestic style furniture, lighting and soft furnishing. Both ground and first floors have easily accessible communal toilets to meet the needs of the residents. The inspector noted that one toilet on the ground floor, had an unpleasant odour, was in a bad decorative state of repair and needed attention to the flooring. A requirement has been made to ensure that this toilet is made serviceable to the residents. The home has received an occupational therapy report in regard to the environment, but the inspector noted that the recommendations in this report had not been met, in particular that handrails had not been fitted in communal hall ways. The inspector is making a requirement that hand rails are fitted in the communal hallways to assist the residents in moving about the home. The inspector was able to view several of the residents’ bedrooms, all were of a good size, and well furnished, all bedrooms contained items of the residents’ personal belongings. All residents spoken to during a tour of the building told the inspector that they were very pleased with their bedrooms, and found them to be comfortable. All bedrooms are naturally ventilated, have central heating, and radiators are in the process of being covered, residents have been provided with bedside lighting unless they have stated otherwise, and it was noted that care plans have signed letters attached which state those residents who do not wish to have bedside lighting. The home has emergency lighting in all communal areas. The inspector checked water temperatures from hot water outlets and this conformed with the standard. There were some parts of the home that had offensive odours and the inspector pointed these areas out to management and staff. The laundry room, was not very clean, and the inspector noted that dirty dish cloths and cleaning cloths in containers were soaking in dirty water in the sink and on the floor area of the laundry. The laundry itself was grubby and in need of a cleaning programme. All the washing machines complied with the standard. The inspector has made a requirement regarding offensive odours in the home and the cleanliness standard of the laundry area. Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 18 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, 28, 29, 30 Staff morale, although improving remains low resulting in some staff turnover and sickness that does not offer consistency of care to the people using this service. Recruitment policies have not been consistently followed resulting in residents receiving care from staff who have not been appropriately vetted. EVIDENCE: The inspector noted that throughout the two days inspection, and by viewing the staff rotas that the staffing levels in the home now comply with staffing levels as indicated by the residential forum. Evidence was available to show that management are still actively trying to recruit staff, and at the present time some agency staff are being used. Despite this compliance the inspector still has concerns in regard to the skill mix of the staff, and issues around poor practice in the administration of medication and some poor care practices witnessed during the inspection visit, therefore a requirement has been made that the skill mix of staff is adequate to meet the assessed needs of the residents. At the present time the inspector found when viewing staff files and the training matrix, that 42 of the staff have an NVQ qualification, two members of staff are waiting to start NVQ training. The inspector was able to view staff files which showed that references, POVA first and CRB checks had been applied for, but in the case of a long term member of staff there was no CRB check available and a requirement has been made to ensure that all staff files contain CRB checks. The inspector noted when viewing the recently updated training matrix that not all staff had received mandatory training within the first six months of their employment and a requirement has been Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 19 made to ensure that all staff receive mandatory training. Within the staff personnel files there was an array of induction packs none of which had been completed, and therefore another requirement has been made to ensure that all staff receive induction within the first six weeks of their employment, and that this induction must meet the National Training Organisation guidelines. Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 20 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) 31, 32, 35, 36, 38 The home is not well managed having a detrimental impact on all aspects of the residents care and support. EVIDENCE: At the present time the home does not have, an acting or registered manager. A registered manager has been brought in from another home within the company. The regional manager is at present in the home during the week, and the relief manager has only been overseeing the home for one week. During the inspection there was not evidence of an open, positive management approach in the home. The inspector was shown the accounts procedure for looking after residents personal allowances, and this showed that all the residents accounts were kept up to date and audited by the administrator and regional manager each month. Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 21 The inspector requested evidence of regular staff supervision, which was not available, and staff spoken to said they had not received any form of regular one to one supervision. The inspector has made a requirement that all staff are supervised at least six times per year. From records seen by the inspector, it was evident that not all staff have received basic mandatory training. The inspector was able to evidence via the files that up to date maintenance certificates are kept in relation to all equipment used in the home. The inspector did not see evidence of an up to date policy and procedure for maintaining safe working practices, and there was no evidence that a recent building and environment risk assessment had been carried out therefore a requirement has been made for the home to issue a policy on safe working practices and this should include an environmental risk assessment. While the home does receive reports under regulation 37, and a record is kept of accidents, accident forms and regulation 37 reports are not always completed correctly, and a requirement has been made in relation to this. Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 22 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 2 2 2 1 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 1 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 2 2 3 3 3 2 STAFFING Standard No Score 27 2 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 1 1 x x 3 1 x 1 Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 23 YES 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. 2. Standard 1 2 Regulation 5 5 Requirement The service user guide to include all information as required by regulation 5 All contracts/statements of terms and conditions to include information in regard to room number, fees payable and by whom they will be paid. Contracts/statements of terms and conditions to be signed by the resident or their representative. Pre-admission assessments written by Care Managers should be fully completed and acurately reflect the care needs of the prospective resident. Staff individually and collectively have the skills and experience to deliver the services and care which the home offers to provide (Previous timescale of IMMEDIATE not met) Care plans are clearly written, and accurately describes the care to be given, and who will administer the care.(Previous timescale of 1/08/05 not met) Care plans should be reviewed on a monthly basis and clearly reflect any changes that need to H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Timescale for action 3/10/05 3/10/05 3. 3 14 1/09/05 4. 4 18 1/09/05 5. 7 15 1/09/05 6. 7 15 01/09/05 Riverlea House Version 1.40 Page 24 7. 8 12 8. 9. 8 8 12, 13 12, 13 10. 11. 8 9 14, 17 12, 13, 16, 17 12. 9 13, 17 13. 15 16 14. 16 22 be made to the original care plan.(Previous timescale of 1/08/05 not met) Care staff to accurately record all personal care tasks, to ensure that residents needs are being met. Tissue viability is regularly assessed in regard to residents at risk. Records are accurately kept of external medical professionals who visit the residents in relation to their physical and mental health. Nutritional screening takes place on a regular basis, and appropriate records are kept. The registered person ensures that there is a policy and staff adhere to procedures, for the receipt, recording, storage, handling, administration and disposal of medicines(Previous timescale of IMMEDIATE not met) In residential care homes, all medicines, including controlled drugs are administered by designated and apopropriately trained staff. The administration of controlled drugs is witnessed by another designatged, appropriately trained member of staff. The training for care staff must be accredited (Previous timescale of IMMEDIATE not met) Residents should receive a varied, appealing, wholesome and nutritious diet, which is suited to individual assessed needs and recorded requirements. The registered person ensures that there is a simple, clear and accessible complaints procedure which includes the stages and 1/09/05 1/09/05 1/09/05 1/09/05 22/08/05 22/08/05 2/08/05. 1/09/05 Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 25 15. 16. 19 21 23 23 17. 22 16, 23 18. 26 12, 13, 16, 23 timescales for the process and is made availabe to all residents and visitors to the home. Grounds are kept tidy, safe, attractive and accessible to the residents. Communal toilets need to be kept in a hygienic, well maintained condition so they are accessible for the residents. The home provides, grab rails and other aids in corridors, bathrooms, toilets and communal rooms to meet the assessed needs of the residents The premises are kept clean, hygienic and free from offensive odours throughout and systems are in place to control the spread of infection, in accordance with relevant legislation and published professional guidance. (Previous timescale of 18/07/05 not met) 1/09/05 21/09/05 21/09/05 1/09/05 19. 20. 21. 22. 23. 29 30 30 38 38 19 All staff to be CRB checked. 12, 18 All staff receive mandatory training within the first six months of their employment. 12, 13, 18 All staff to receive induction training in line with the NTO guidelines. 17, 37 All accidents must be reported in detail and forms completed correctly. 12, 13 The home should have a written statement for maintaining safe working practices and this should also include an environmental risk assessment. 1/09/05 1/10/05 1/09/05 1/09/05 1/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 26 No. 1. 2. Refer to Standard 28 33 Good Practice Recommendations Staff continue to be enrolled on NVQ courses to ensure that 50 NVQ trained staff are on duty on every shift. Policies, procedures and practices are regulary reviewed in light of changing legislation and of good practice Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 27 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU 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 Riverlea House H56-H05 S23537 Riverlea House V234491 030805 Stage 4.doc Version 1.40 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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