Inspection on 06/07/07 for Rivermead Care Home

This inspection was carried out on 6th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

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

CARE HOMES FOR OLDER PEOPLE Rivermead Care Home 123 Scarborough Road Norton On Derwent Malton North Yorkshire YO17 8AA Lead Inspector Mrs Jean Dobbin Key Unannounced Inspection 09:10 6th July 2007 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 Rivermead Care Home DS0000069333.V334430.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. Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rivermead Care Home Address 123 Scarborough Road Norton On Derwent Malton North Yorkshire YO17 8AA 01653 696942 01653 691894 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) Barchester Healthcare Homes Ltd Mrs Colleen Coral Moore Care Home 60 Category(ies) of Dementia (30), Dementia - over 65 years of age registration, with number (30), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (30), Old age, not falling within any other category (30), Physical disability (1) Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Service users in category DE must: (I) be over 55 (ii) require nursing care Service users in the categories DE(E), DE and MD(E) will be accommodated in the dementia unit (Malton). Service users in the category OP must be accommodated in the general nursing unit (Westow). The category PD is specific to the service user identified in application number V33100 and is accommodated within the general nursing unit. Date of last inspection Brief Description of the Service: Rivermead is a nursing home currently providing care for up to a maximum of 60 older people. The home is located in Norton, which has local amenities. Norton is very close to the market town of Malton, which has more services and rail links. The home has two distinct units each for up to 30 people. Those with general nursing needs are on Westow Unit, and those people with dementia and mental health needs are on Malton Unit, which has access via a door with a keypad. This building is purpose built on one level, with wellmaintained gardens for residents and their families to enjoy. The home is currently having an extension built, which will increase the numbers of people living on Malton Unit, as well as improving the environment and facilities for those already living on that Unit. Details provided in April 2007 outline the weekly fees as between £500 and £750. Additional charges are made for hairdressing, chiropody services, complementary therapies and individual items like newspapers. The service provides information about the home to prospective residents within a Welcome Pack. Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection report follows a visit to the home on 6th July 2007 by two inspectors. The visit lasted about 7.5 hours. This is what was used to write this report. • • • Information about the agency kept by the Commission for Social Care Inspection. Information asked for, before the inspection. This is called a Pre Inspection Questionnaire. (PIQ) Information from surveys, which were sent to people who live at Rivermead, their relatives, and other professional people who visit the home. 12 were sent to people who live at Rivermead and 8 were returned. 12 were sent to relatives of people who live there and 8 were returned. 3 were sent to care managers though none were returned. 1 was sent to a GP, who completed and returned the form. A visit to the home. This visit included talking to residents and visitors, and to staff and the manager about their work and training they had completed. It also included checking some of the records, polices and procedures that the home has to keep. • Information about what was found at the visit was given to the registered manager when the inspection was over. What the service does well: People like living there. Comments from people on Westow include. “I have no complaints at all, the staff are so kind,” and “it’s very nice. I can’t grumble”. One relative said about Malton Unit. “The care is excellent. We feel so pleased is here”. The decoration and furnishings are to a superior standard to enhance the environment for the service users. The outside area at the front of the building is also very attractive. There is always a lot going on both in and away from the home. Two activities organisers provide different events and ensure that more impaired people can still access this support. The activities programme is presented in both written and picture format, to aid communication about the planned events. Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 6 The manager recognises that the people who live there should be influencing how the home runs and is introducing ways in which they can say what matters to them. Visiting family members, spoken with, describe Rivermead as a very happy place, where they are always made to feel very welcome. What has improved since the last inspection? What they could do better: Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 7 Those people developing short-term health problems still require a plan of care to show how that problem is to be managed. This will make sure that all the care staff know about it and the person can receive safe, consistent care. The fire door into the dining area on Malton Unit is still being propped open with a chair. Whilst recognising that the fire safety systems on this unit will be changed when the building work is completed this present management is unacceptable and could place people at risk in the event of a fire. The hot water systems are not working properly. Hot water temperatures can not be controlled within safe limits and people are being put at risk of scalding. This is unacceptable and needs addressing urgently by the company. Staff must not start working at the home until two satisfactory references have been received, so that their suitability to work in the care sector can be checked. The service should continue to support staff so that 50 of carers have a Level 2 National Vocational Qualification in Care. People are more likely to receive safe, consistent care from carers who have a good understanding of their role. 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. Rivermead Care Home DS0000069333.V334430.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 Rivermead Care Home DS0000069333.V334430.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): 3 and 6. People who use this service experience good quality outcomes in this area. People who decide to use this service can be assured their needs will be assessed to make sure that staff at the home, are able to meet those needs. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Four care records looked at each contained an assessment completed before they moved to the home. These explored their physical, emotional and social needs and made sure that the home could meet their needs before they decided whether to move there. Information booklets are sent out to anyone making enquires about the home. Eight surveys completed by people who live there reported that six had received enough information about the home prior to moving there. One person said that their relative had been shown around the building, met the Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 10 staff and discussed the care that would be needed if they were to move there. They said the way this was carried out was “very impressive.” This pre-admission process makes sure that the staff at the home can care and support the person properly and reassures a prospective resident that their total needs can be met if they choose to move there. Intermediate Care is not provided at Rivermead. Rivermead Care Home DS0000069333.V334430.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. People who use this service experience good quality outcomes in this area. People who live at Rivermead have a detailed assessment plan in place and their personal, social and health care needs are generally well met. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Five care records were examined during the visit. These all had plans of care that were individualised, which means they were all very different from each other. They describe the care and support that different people require. These records were generally reviewed monthly to make sure the information was still relevant. Risk assessments were carried out to identify which people were at risk of developing bedsores, of having repeated falls, and becoming malnourished because of health problems or poor appetite. Plans were in place to say how these risks were to be minimised. Other risk assessments had been carried Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 12 out to identify the safest and most appropriate way of moving the person. Whilst two people spoken with knew that they had care records they said the contents had not been discussed with them. This would be good practice so that individuals have the opportunity to say what is important to them. Other records included a weekly assessment of wounds to demonstrate whether treatments were appropriate, and detailed information about how to manage difficult behaviour. For example ‘sit down with them and stroke their hand’ and ‘acknowledge their feelings even though their speech may not be logical’. One person though had developed a temporary problem, which affected their ability to move around the home as usual. There was no review of their moving and handling risk assessment to reflect this change, nor a care plan written to describe how this short-term problem was to be managed. This was discussed with the head of Unit. There were also records of whether individuals had a preference for a male or female carer to support them with their personal care. This choice could then be respected whenever possible. People living at the home said they liked living there and the care was excellent. One commented. “Nothing is too much trouble”. People looked well cared for. Staff seemed to have more time on Westow to talk with the residents compared with the last visit and they were observed knocking on bedroom doors before entering. On Malton Unit staff were observed interacting gently and kindly with the people who live there. One person though commented that because their relative was less impaired than some of the other people, they didn’t get as much attention from the carers. There was a record of visits from the GP, chiropodist and physiotherapist. Two GP’s visited the home on the day of the visit and one from the local surgery holds a weekly ‘surgery’ at the home. The survey form completed by a GP did not show any concerns. However whilst one person said that the staff “always telephone me to report incidents”, another said. “They don’t always update me on doctors’ visits or changes in medication”. Medication processes on both units are generally satisfactory. The monitored dosage system is in use and checks are carried out routinely to be sure that the actual number of tablets in non-blister packed containers is the same as the actual amount. This confirms that the drugs are given and signed for according to prescription and was a failing noted on the last report. Drug records are signed appropriately with no gaps where signatures are missing. Staff spoken with had a good understanding of ordering, and storing stock and also of disposing of unwanted drugs. Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 13 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. People who use this service experience good quality outcomes in this area. People are able to live the life they choose and receive a varied and nutritious diet. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: People who live at the home are supported to make choices about their day-today lives. On Malton people get up and go to bed when they choose and breakfast, cooked if required, is made available throughout the morning. The bedroom doors on Malton though are still self-locking, although a few of the people living there do have their own key. One person spoken with said they had been promised a key. This was discussed with the manager, who promptly found one for them. The locks on this unit are to be changed with the refurbishment later this year. The people living on Westow also confirmed that they decide when to go to bed and get up. There are two activities organisers who provide a weekly programme, which is displayed around the home and is in a picture format. Examples of activities Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 14 include ‘crosswords and puzzles’, ‘exercise with balloons’ and a ride out in the home’s minibus. One to one work enables the activities staff to spend time with people living at the home who are more impaired, or in bed. Religious services are held at the home and a volunteer visits each week to play dominoes. One person said how much they had enjoyed a trip the previous week to a shopping centre in York. Relatives commented “My relative loves it here” and “my relative particularly likes the singing and sways to music in their chair”. A gardening club has been established. On the day of the site visit there was a quiz on Westow. About twelve people took part and there was a lot of banter, with people clearly enjoying the event. Residents and relatives meetings have been started and these take place three monthly and are minuted. It may be helpful for the chef and a housekeeper to attend these meetings so that any comments about the meals, the laundry and the cleanliness of the home can be addressed directly. There is a new chef employed at the home who previously worked at another care home. All the catering records looked at were in order and all stored food was labelled and dated properly. (This good practice was not being followed when visited last year). Both staff and the people who live at the home feel that the meals are very good, with a range of alternative choices. The dining room on Westow was observed to be a relaxed place to eat, with enough staff to assist people in an unobtrusive manner. The dining experience was calm and the meal was a pleasant social event. Condiments and sauces were available and the menu was displayed. On Malton the staff eat with the people living there, so the meal becomes a social occasion. There are plans to take photographs of the meals to help people to choose what to eat. Comments include “the food is very good and always hot” and “ the home provides a wide range of alternative menus. One person though said that the portions were too large and sometimes over-faced people. This was discussed with the manager. The coffee and afternoon tea rounds were also observed. Staff were seen sometimes giving biscuits and cakes to people, rather than letting them choose for themselves. This takes away people’s choice and control and these practices were discussed with the manager. Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 15 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. People who use this service experience good quality outcomes in this area. People feel their complaints are taken seriously and there are systems in place to protect them from harm. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: All survey responses from the people who live there said they knew how to make a complaint. This was also confirmed when speaking to people at the home. The complaints process is displayed in the entrance foyer. One relative said that a complaint they had made in the past had been dealt with promptly and to their satisfaction. There have been no complaints made to the Commission. However the home has received one, which was addressed promptly and appropriately by the manager. Records kept at the home confirmed this. It would be good practice though to make a record of the final discussion held with the complainant, and obtain their signature to demonstrate that they are satisfied with the way their concerns were handled. People spoken with said they felt very safe living at the home. Advocacy leaflets are displayed in the foyer and details about these services are included in the information given to people and their families when they move to the Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 16 home. Staff attend annual training in Safeguarding Adults, although this training is overdue for some individuals. The training officer at the home is addressing this. All staff spoken with understood their responsibilities should they hear or see something they are concerned about and two staff members explained that the home’s whistle-blowing policy is explained in their employee handbook. The manager was also clear about her role should someone come to her with an allegation of abuse. All staff have a Criminal Records Bureau check, and if necessary a PoVAfirst check before starting work, to make sure they are not barred from working in a care environment because of a previous offence. (Though see Standard 2730). These processes are carried out to protect people living there from harm. Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 17 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 and 26. People who use this service experience good quality outcomes in this area. People live in a clean, comfortable and well-maintained home. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: A tour of the home confirmed that Rivermead is clean, well maintained and attractively furnished. The paved area outside the main entrance is particularly attractive with many planted containers, a well-maintained small garden area and outside seating where people can enjoy the flowers. People who are in the gardening club at the home were involved in putting this display together. The home is in the final of two categories for the annual ‘Barchester in Bloom’ competition. Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 18 There has been redecoration of the lounge, one new bathroom and ten bedrooms on Westow, and also a small office has been constructed to provide more privacy when talking about people who live there. The shower/hairdressing room on Malton has also been redecorated. Once the new build is completed on Malton Unit, later this year, there are plans to redecorate the communal areas and corridors there, to provide a more unified and appropriate décor and make it easier for people living there to find their way around. Most of the private rooms have en-suite facilities and those looked at had been personalised with photographs and ornaments. Those rooms on Malton had a boxed frame on their bedroom door, where photographs and mementoes are displayed as a way of helping people to recognise their own room. One bedroom on this unit however smelled of urine and this needs addressing. An improved call bell system in the lounge on Westow means that people there are more easily able to summon help. The call bell system is going to be relooked at when the system is installed in the new extension. There are enough assisted bathrooms on both units. Although some of these are used for storing large moving and handling equipment the staff spoken to, said that there were still enough bathrooms. The laundry area although satisfactory had a broken keypad on the door, which meant that access to the chemicals and ironing equipment, could not be restricted. One member of staff said it had been broken for “quite a while”. The maintenance person ordered another keypad that day. Cleaning cupboards containing chemicals were all locked. Staff spoken with said that there were always enough aprons and gloves and were observed wearing them. Alcohol handwash was seen at various places around the home. These systems help to prevent the spread of infection around the home. Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 19 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. People who use this service experience good quality outcomes in this area. Whilst people receive good quality care from well-supported and wellmotivated staff, shortfalls in recruitment processes may be putting people at risk. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Each unit has six carers on an early shift, five on a late shift and three through the night. This number includes two trained nurses on each unit during the day and one on each unit at night. The rota though for Westow unit for weekend 7th and 8th July states that only one nurse was on duty during the day. Unlike at the last inspection most people on Westow choose to stay up longer in the evening so care staff are able to meet those requests more easily. One person said that they chose when to go to bed and generally staff manage to help them at the time they choose. One person said it was “very nice” at the home. They said they felt very safe when they were being moved with the hoist and also felt the staff were competent when using it. Another added that, “the carers are very helpful and try to solve any problems. They are polite and cheerful”. Less than 50 of care staff have achieved a Level 2 National Vocational Qualification. People Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 20 are more likely to receive safe, consistent care from staff, who have good knowledge and understanding of their roles and responsibilities within the home. Staff said that they had attended mandatory training such as fire safety, moving and handling, safeguarding adults and health and safety and the training plan generally confirmed this. The training officer is aware that some training is outstanding and this is being sorted. The training records have been brought up to date so that it is easy to identify who needs a training update. Three nurses on Malton have mental health qualifications. Staff from this unit have visited another Barchester home to learn more about the value of reminiscence work for people with dementia. Some of these ideas are to be implemented when the building work is completed. Two members of staff on Westow have attended palliative care courses to give them better understanding of the needs of people with life limiting illnesses and their families. One person said that the staff are very aware of palliative care needs. Comments from surveys include “I am more than satisfied with the care and support received from the staff at the home” and “ the staff are very kind, though they are pressed a bit hard sometimes” and “all the staff are affectionate and friendly with the residents”. Two recruitment files were examined. Whilst one contained all the checks necessary before a new employee starts work, the second person started work when only one reference was back. A Criminal Records Bureau check had been carried out before this person started work to make sure they were not barred from working with people because of a previous offence. This shortfall was discussed with the manager as this poor practice could be putting people living at the home at risk. Staff now attend Induction training before starting work ‘on the floor’. This means they have the opportunity to have a planned training in a consistent manner without interruption. The training officer makes sure these records are up to date. People are more likely to receive consistent, safe care from staff who have attended similar introductory programmes. Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 21 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, 33, 35 and 38. People who use this service experience good quality outcomes in this area. The home is well run and the welfare of the people who live and work there is recognised as very important. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: There is a new manager at the home, who has been registered with the Commission. She is an experienced nurse, who has managed other care homes and has a good understanding of the diverse needs of the people who live there. She has demonstrated strong leadership and has made a number of changes since her appointment. She is described in survey responses as “approachable” and “enthusiastic”. She believes in an ‘open door’ policy and one person at the home said that she was “very nice and easy to talk to”. Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 22 Barchester has a range of processes in place, which allow the home to monitor its own performance. These include ‘the dining experience’, ‘health and safety’ and ‘medication’. The manager also carries out her own spot checks at different times of the day and night to satisfy herself that good standards are being maintained. The home now produces its own newsletter to keep people up to date about what is happening in the home and quarterly residents and relatives meetings take place. These give people living there the opportunity to influence how the home runs. Barchester carry out an anonymous customer satisfaction survey each year and monthly checks of the home are undertaken by a senior regional manager. The manager sends in notifications about serious or untoward events to the Commission so that these events can be monitored. The service looks after the personal monies for four people. This money is held in one non-interest earning account. All transactions are recorded and computerised records are kept. These systems demonstrate that peoples’ financial interests are safeguarded. Whilst care staff generally receive personal supervision every two months the records provide little information about any the issues discussed. However staff also attend ‘support sessions’ where the documentation is more detailed. These sessions do not happen so regularly. Information provided from the pre-inspection questionnaire and the examination of selected health and safety documents showed that regular checks to gas and fire safety equipment are regularly undertaken. There is a maintenance person employed at the home who carries out daily, weekly and monthly checks so as to maintain the safety of the premises. Fire alarm checks are carried out weekly, and the last fire drill was two months ago. There are a range of health and safety policies and procedures in place. The home has made proper provision to ensure that there are safe working practices by providing staff training in first aid, fire, food hygiene, infection control and safe moving and handling techniques. Hazardous products are generally stored appropriately and records are maintained as required. However the keypad to the laundry area was noted to be broken, which meant access couldn’t be restricted. Hot water temperature checks are currently carried out three monthly however all hot water sinks, to which people have access, should be checked monthly to reduce the risk of people getting scalded by water that is too hot. The home has had a problem with maintaining these temperatures within safe levels in recent months. Although the problem has been assessed and a cause found, there has yet to be action taken to correct this. Temperatures range between 15 and 56°C. This is unacceptable and requires urgent attention. Following the site visit the manager is addressing this as a priority with her senior managers. Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 23 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 1 Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? New service 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 OP7 Regulation 12 (1) Requirement Plans of care must be written for all health problems so that people receive consistent care from well informed staff. From the date of this visit no person should be employed without two satisfactory references so that people living at the home are not put at risk. a) The unpredictable hot water systems at the home must be sorted out, so that people are not being put at risk of scalding. b) Hot water temperature checks should be carried out monthly on all taps to which people living at the home have access. This will minimise the risk of people being scalded. Fire doors must only be held open by means acceptable to the fire service, so that people are not put at risk in the event of a fire. Timescale for action 31/08/07 2 OP29 Sch 2 Reg 19 06/07/07 3 OP38 12(1) 31/07/07 4 OP38 12(1) 06/07/07 Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 25 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 OP28 Good Practice Recommendations The manager should continue to work towards achieving 50 of the care staff holding a Level 2 National Vocational Qualification in care. Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 © 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 Rivermead Care Home DS0000069333.V334430.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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