CARE HOMES FOR OLDER PEOPLE
Riverlee Care Home Franklin Close Off John Penn St Greenwich London SE13 7QT Lead Inspector
Maria Kinson Unannounced Inspection 3rd July 2007 09:35 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 Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 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. Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Riverlee Care Home Address Franklin Close Off John Penn St Greenwich London SE13 7QT 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) 020 8694 7140 020 8694 7141 rebeccas@sanctuary-housing.co.uk Sanctuary Housing Association (trading as Sanctuary Care) Mrs Rebecca Francisco Sowle Care Home 75 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (60) of places Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21st June 2006 Brief Description of the Service: Riverlee Care Home is a purpose built home, which is owned and managed by Sanctuary Care. The home was registered in December 2001 to provide care and accommodation for 75 older people. The home is located in the London Borough of Greenwich and is close to local shops and bus routes. Accommodation is provided over three floors. There are five units in the home, each providing separate services, having its own staff team, communal space and bathing facilities. On the ground floor ‘Chelmer’ provides personal care for fifteen older people with dementia. On the first floor there are two fifteen bedded units ‘Yeading-Brooke’ 1 and 2 which provide nursing care for older people with dementia. On the second floor there are two fifteen bedded units, ‘Ravensbourne’ 1 provides nursing care for older people with dementia and ‘Ravensbourne’ 2 provides nursing care for older people. All of the bedrooms in the home are single occupancy with en-suite facilities. At the rear of the property there are small garden areas with flowerbeds and lawns and there are a limited number of parking spaces in front of the home. The fees charged by the home range from £475- £785 per week. This does not include additional charges such as chiropody, hairdressing, newspapers and outings. This information was provided to the commission on 13.06.07. Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place on 3rd July 2007 and was unannounced. Two inspectors spent over nine hours in the home. Most of the time was spent talking to residents, staff, two health care professionals and two visitors on Yeading Brooke 1 and 2 and Ravensbourne 1 and 2. All of the communal areas and a selection of bedrooms on these units were viewed and various records were examined. A random sample of residents, relatives and health care professionals were asked to provide written feedback about the service. The commission received eight comment cards back from relatives, six from health care professionals and one from a person that lives in the home. The information provided by residents, relatives, staff and other professionals forms part of this report. The commission visited this home in February 2007 to undertake a random inspection. The report from this visit is available on request from the office listed at the back of this report. What the service does well:
The arrangements for admitting new residents into the home were satisfactory. Staff used the information that was obtained during assessment to decide if the service would be able to meet the person’s needs. The home received regular support from a local GP and other health care professionals. Health care professionals said that staff contacted them if they required advice. Most relatives were satisfied with the visiting arrangements and said that staff informed them about significant issues such as falls and hospital admissions. Residents said they liked their rooms and the people that helped them in the home. The quality and choice of food provided was good and residents said they were able to choose what they ate. Good records were maintained about complaints. There was evidence that all of the complaints logged were investigated properly and action was taken where necessary to improve staff performance. Staff indicated that they would report allegations of abuse to senior staff. Hand washing facilities were good and most people were satisfied with the standard of cleanliness.
Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 6 Good records were maintained about resident’s money and valuables. There were good systems in place to monitor and identify health and safety concerns and to check that fire safety equipment was working. The home obtained regular feedback from residents and relatives and used this information to improve the service. What has improved since the last inspection? What they could do better:
Care records had improved but further work was required to ensure that records reflected people’s individual needs, preferences and routines. This information would enable staff to provide personalised care and support. Staff should develop separate care plans for people with multiple wounds or sores. This would make it easier to follow the instructions in the plan and allow space for staff to update the plan if the treatment changed. Medicines that were supplied to the home in compliance devices were well managed. The balance of some medicines that were supplied in packets and boxes was incorrect. Staff must ensure that accurate records are maintained particularly if residents refuse to take their medication. The manager should ensure that medication audits assess this issue. Staff had written residents
Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 7 room numbers on some medication containers. This practice could lead to errors. Complaints were investigated properly but the file that was used to store complaints should be reorganised to make easier for the reader to locate information about how many complaints the home had received, whether there were common themes, whether the complaint was upheld and what action was taken to address the persons concerns. The building was well maintained overall but some issues were not reported promptly. Staff should be reminded to record faults and repairs in the maintenance book. Some of the carpets felt sticky. The home had provided some dementia training for staff but some health care professionals and relatives indicated that some members of staff would benefit from further training in relation to caring for people with challenging behaviour and dementia and communication skills. Staff received induction training but the course did not cover all of the recommended standards. The home did not always carry out adequate checks or obtain all of the necessary documentation before staff started working in the home. This could compromise resident’s health and safety. 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. The summary of this inspection report can be made available in other formats on request. Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 8 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 Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 4. Standard 6 does not apply to this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff carried out a care needs assessment before confirming if the home could meet a person’s needs. EVIDENCE: A copy of the ‘Service User Guide’, an information booklet for residents, was provided in each bedroom. People that were referred to the service were assessed by a senior member of staff before they moved into the home. The exception to this was residents that were admitted very quickly as an emergency. The assessments were usually undertaken in the persons home or in hospital and there was evidence that relatives and hospital staff were consulted if the prospective resident was
Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 10 not able to provide adequate information. Pre admission assessments were comprehensive in content and provided adequate information for staff to meet the person’s needs on admission to the home. Records showed that staff also obtained other written information about the person’s needs and medical history from the funding authority. After the assessment staff wrote to the prospective resident to advise them if the home was able to meet their needs. Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Records had improved and work was in progress to develop person centred plans that reflect individual needs and preferences. Staff worked in partnership with other professionals to ensure that resident’s health care needs were met and their privacy and dignity was maintained. Medication records were generally up to date but staff could not account for some of the medicines that were used in the home. EVIDENCE: Four sets of care records were assessed. All of the records seen provided information about peoples needs, a plan of care to meet the needs identified and information about potential risks. A number of care plans that described the action that staff should take to meet peoples hygiene needs were very similar. It is very unlikely that all of the people who had this type of care plan liked to bath once a week, at any time of
Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 12 the day and had no preference about the type of toiletries that were used. The home had identified this issue during care record audits and was now providing ‘one to one’ mentoring and support for staff to prepare person centred plans. There was evidence that care plans were discussed and agreed with relatives and were followed by staff. For example one care plan stated that two staff and the standing hoist was required to move a resident and the residents feet should be elevated. The relative of this resident said he was aware of his family members care plan, had observed staff transferring his family member in the manner described in the care plan and that a stool was provided to elevate her feet whilst sitting. One resident had returned from hospital with three sores. Staff had developed a care plan to state how the wounds should be managed and were maintaining a wound care evaluation form so that staff and other professionals could see if the wound was improving. The care plan and evaluation form was rather difficult to follow because information about all of the different wounds and advice from a Podiatrist and a Tissue Viability Nurse was included in the care plan and wound evaluation sheet. Staff should maintain separate care plans and wound evaluation sheets for each sore/wound. This will make it easier for staff to follow the guidance provided. Care plans were reviewed monthly or more frequently if required and most of the plans seen were agreed and signed by the resident or their relative. Access to community health care services was satisfactory. Records indicated that some residents had seen a GP, Chiropodist and Dental Hygienist in recent months. Most relatives said that the home was able to meet their family members needs and kept them informed about significant issues. Six health care professionals that were in regular contact with the home, provided written feedback about the service. The respondents said that staff obtained advice about health care issues if required and were able to meet people’s health care needs. One person said the service was particularly good at “encouraging a multi disciplinary approach to care”. Two people indicated that some members of staff required “dementia and behavioural problems” training and support from senior staff. See standard 30. Some of the care plans identified health care issues such as problems with nutrition or the management of diabetes. One care plan stated that a resident required a soft high fibre diet, supplement drinks and should have 1.5 litres of fluid each day. Advice had been sought from the GP and dietician and staff were monitoring the resident’s food and fluid intake. The care plan for a resident with diabetes stated that the persons blood sugar level should be checked twice a day and regular attention was required to finger and toenails. A chiropodist saw the resident on the day of the inspection and records of blood sugar levels were seen in the resident’s notes.
Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 13 The management of medication was assessed on two units (Ravensbourne 1 and 2). Medicines were stored appropriately and the medicine room and refrigerator temperature was closely monitored. Records of receipt and disposal of medicines were good. Medication that was supplied in compliance devices was well managed but four discrepancies were noted with medicines that were supplied in packets and boxes and some charts did not include a photograph of the resident. Discussions with staff indicated that this was likely to be due to record keeping errors. Staff had applied people’s room numbers to some of the medicine containers. This practise poses a risk to residents as staff might rely on the room number and not check the label properly. If a resident was to change room or leave the home there is a risk that the resident that moved into their room could receive their medication. See requirement 1. The list of homely remedies was agreed and signed by the GP and good records were maintained about the receipt and disposal of these medicines. Residents said that staff treated them with respect and maintained their privacy. Residents, health care professionals and relatives said staff were “professional”, “kind and helpful” and “dedicated and caring”. Staff responded to residents in a professional manner. Residents were appropriately dressed. Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provided a regular programme of activities to meet peoples but residents did not have an opportunity to go out. Relatives said they were able to visit at anytime and could spend as long as they liked with their family member. Most people said they were satisfied with the choice and quality of food provided and enjoyed their meals. EVIDENCE: Information about resident’s personal interests and social history was recorded in most of the files seen. Staff requested information from family members or friends if people were not able to recall certain events or details about their life. Residents that the inspectors spoke with were aware of the activities programme and said they had taken part in arts and craft sessions, bingo, games and quizzes in recent weeks. Records indicated that residents were encouraged to take part in some of the sessions listed on the programme and activities staff also spent some time talking or providing hand massages for
Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 15 people that were confined to bed. One resident showed the inspector some of her artwork, which was displayed in her room and said she was looking forward to a party and entertainment on her birthday. There were five outings planned for July and August to Hever Castle, The London Eye, Hastings, Leeds Castle and Eltham Palace. Religious services were held regularly. The manager said that the home had been assessed for possible inclusion in a research project about activities for people with end stage dementia. The manager was waiting to hear if the home had been chosen. Relatives said they were able to visit their family member at anytime and were able to spend as long as they liked in the home. One relative told the inspector that he usually visited during the lunch period to help his family member to eat and was happy to assist with this task. There was evidence that people were able to make decisions about how and where they spent their time and were offered choices about what they wore and what they ate. Care plans made reference to maintaining people’s privacy and dignity and promoting independence and choice. The serving of lunch was observed on two units. Residents were able to choose what they wanted to eat from the menu and some residents had requested alternatives such as a salad or vegetarian meal. The food looked and tasted appetising. Tables were nicely laid out but condiments and sauces were not offered or provided on the tables. The inspectors were told that new salt and pepper pots were on order. Staff provided assistance to eat if necessary. A relative that was helping his family member to eat said he visited the home regularly and always found the food to be varied and good. Residents provided similar feedback about the food provided in the home. Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had procedures in place for investigating concerns, complaints and allegations. EVIDENCE: The complaints procedure was displayed in the main reception area. Copies of the Service User Guide were seen in resident’s rooms. This booklet includes information about the homes complaints procedure. Relatives and residents were familiar with the homes complaints procedure and said they would speak to staff, the manager or activity staff if they had any concerns. Complaints were recorded in a file. Some of the complaints in the file were difficult to follow because it was not clear where the information relating to each complaint started and finished. The file also included several old complaints. See recommendation 1. The home had received eight complaints since the last key inspection. The manager or deputy manager investigated complaints and usually wrote or met the complainant to discuss their findings. One member of staff was disciplined and received retraining as a result of an investigation and another member of staff was dismissed. Complaints were investigated and dealt with appropriately and the commission was notified about significant events.
Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 17 Staff had a good understanding of abuse and knew what they should do if they witnessed or were told about an allegation of abuse. Some members of staff said they had attended abuse training in the home or had covered this topic when they completed vocational qualifications. The manager was aware of the need to notify the commission and social services about allegations of abuse. Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean and comfortable but staff did not always report repairs and maintenance issues promptly. EVIDENCE: All of the communal areas and a selection of bedrooms on Yeading Brooke 1 and 2 and Ravensbourne 1 and 2 were inspected. All parts of the home were clean, tidy and odour free but a few carpets were stained and felt sticky. A few maintenance issues were identified such as a broken radiator in shower room 2 and an unrestricted window and broken window blind in the en suite area in room 27. Several baths were awaiting repair. A number of these issues were not recorded in the repairs book. See recommendation 2. The shower room on Yeading Brooke 1 looked rather clinical and uninviting. See recommendation 3.
Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 19 Since the last inspection some of the bedrooms and lounges had been redecorated and staff were starting to develop a reminiscence room on Ravensbourne. Bedrooms were suitably furnished and spacious. Some of the bedrooms included items such as family photographs and personal belongings and furniture from resident’s own homes. This made the rooms look more homely and welcoming. Key workers should assist residents that do not have relatives to personalise their rooms. The grounds at the front of the home were well maintained and the home had received a grant from the Department of Health to provide a sensory garden, purchase a gazebo and to increase the height of some of the perimeter fencing to provide more privacy for residents. The manager said this work would take place in July 2007. Hand washing facilities were provided where clinical waste or infected material was handled. Protective equipment was provided for staff. Domestic staff had received training about the use of hazardous chemicals and cleaning materials were stored securely. Ventilation in the bath and shower rooms was unsatisfactory. The Commission was notified on 20.07.07 that work had been undertaken to address this issue. This requirement has been assessed as met but will be reviewed at the next inspection. Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home did not always undertake adequate recruitment checks when appointing new staff. This could compromise resident’s safety. Access to training was satisfactory but some staff required additional training to support people with dementia. EVIDENCE: The staff team comprised of a full time manager, deputy manager, registered nurses, care assistants, activity coordinators, domestic and ancillary staff. The duty roster showed that there were two nurses and five care staff on each of the nursing floors during the morning shift, two nurses and four carers on each of the nursing floors during the evening shift and one trained nurse and three care staff on each of the nursing floors overnight. On the residential unit there were three care staff on duty throughout the day and two care staff overnight. The staffing levels had not changed in the period since the last inspection. The requirement in the previous report to review staffing levels in view of the dependency of one resident was no longer applicable as the resident was no longer living in the home.
Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 21 The inspector was advised that twenty four percent of care staff had attained a vocational qualification in care at level 2 or above and seven staff were currently undertaking this programme. The number of care staff with a vocational qualification had decreased since the last key inspection. Two staff recruitment files were viewed. The files viewed contained most of the documents and information required by legislation but one nurse had commenced work in the home prior to the manager receiving a criminal record disclosure or POVA first check. There was no evidence that the home had checked that the nurse was registered to practice. See requirement 2. The arrangements for staff training had changed. Work was in progress to provide mandatory and developmental training courses for staff in the home. Three of the senior staff had attended a course for trainers and completed an assessment. The manager said training materials such as DVD’s and guidance would be provided for the trainers and she would still be able to arrange external sessions to meet staff needs. Staff were satisfied with the standard of training and support they received in the home. Discussions with individual staff members and examination of staff training records indicated that some members of staff had attended moving and handling, bedrail, safeguarding adults and first aid training in recent months. Induction training was provided for new staff but the session did not cover all of the common induction standards. See recommendation 4. The feedback from some health care professionals that visited the home indicated that some members of staff required “dementia and behavioural problems” training and more support from senior staff. Interaction between staff and residents was variable. Some members of staff spent periods watching residents or talking amongst themselves. This issue was also identified by one relative who said she found staff sitting together reading magazines. More effort should be made by some staff to engage residents in activities and conversation. Two relatives commented that “staff don’t talk to the elderly people, they just do things to them”; staff should spend more time “talking to people”. See recommendation 5. Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was managed effectively. There were systems in place to monitor and improve the standard of care provided in the home and to safeguard people’s money. Health and safety issues were monitored to ensure a safe environment for residents and staff. EVIDENCE: The manager was assessed by the commission as a suitable person to manage a care home for older people. There was evidence that the manager had undertaken training relevant to her post. Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 23 Staff said that the manager and deputy manager visited the units regularly to support staff and monitor care practices. The home had systems in place for monitoring the quality of care and services provided in the home and for obtaining feedback from residents and relatives. Staff carried out regular audits to monitor compliance with company procedures and the regional manager visited the home regularly to speak with staff, residents and visitors. Residents and relatives meetings were held every three months and the company sent out a detailed satisfaction survey once a year. The results from the satisfaction survey that was undertaken in 2006 indicated that most people were satisfied with the facilities and services provided in the home. The system for dealing with residents’ personal allowances was examined. Two signatures were recorded for money that was handed to staff for safekeeping or was used to pay for services such as hairdressing or chiropody. Receipts were retained for all purchases. The money and valuables held for two people was checked and was found to correspond with the records. The manager agreed to check that there was adequate insurance cover in place in respect of the jewellery that was held in the home. The administrator completed a monthly audit and the Regional Manager carried out ad hoc checks. The systems for safeguarding resident’s money was well managed. A maintenance person carried out routine health and safety checks and repairs. The maintenance person had a reasonable understanding about his role and responsibilities but would benefit from receiving further training about the prevention of Legionella. See recommendation 6. Electrical and gas appliances were inspected regularly to ensure that they were in working order and safe for use. Fire safety arrangements were good. Regular checks were undertaken to ensure that the fire alarm system, emergency lighting, fire extinguishers and fire doors were in working order. Fire safety equipment was serviced regularly and staff received fire safety training updates. Accidents were monitored. A monthly log was maintained about the number and type of accidents that had occurred on each unit and the action that was taken by staff to maintain the persons safety. It was not always clear on the form if relatives were informed but comments from relatives suggested they were usually informed about significant issues. Bed rail assessments were seen in the files for residents that were using this equipment and covers were used to reduce the risk of injury. Some members of staff said they had attended moving and handling training and that information about the use of bedrails was provided during this session. The home had purchased some extra height bedrails since the last inspection. Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 24 Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 25 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 3 X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 26 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 OP9 Regulation 13 Requirement The Registered Person must ensure that staff do not apply room numbers to medication containers and that accurate records are maintained about medicines administered in the home. The Registered Person must not employ a person to work at the care home unless she/he has obtained, in respect of that person, the information and documents specified in Schedule 2. Timescale for action 29/08/07 2. OP29 19 29/08/07 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 OP16 Good Practice Recommendations The Registered Person should consider reorganising the complaints file to make it easier for the reader to see at a glance how many complaints the home has received, if there were common themes, if the complaint was upheld
DS0000006768.V343040.R01.S.doc Version 5.2 Page 27 Riverlee Care Home 2. 3. 4. 5. 6. OP19 OP21 OP30 OP30 OP30 and what action, if any was taken to address the persons concerns. Old complaints should be archived or stored in a separate file. The Registered Person should ensure that all staff are aware of the procedure for reporting faulty or broken items. The Registered Person should consider what action could be taken to make the shower rooms look more inviting for residents. The Registered Person should provide structured induction training for care staff. The training should cover all of the common induction standards. The Registered Person should develop an action plan to improve staff communication and understanding of dementia and challenging behaviour. The Registered Person should ensure that the maintenance technician receives Legionella training. Riverlee Care Home DS0000006768.V343040.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection SE London Area Office River House 1 Maidstone Road Sidcup Kent DA14 5RH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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