Inspection on 31/05/06 for Rivers Reach

This inspection was carried out on 31st May 2006.

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

Rivers Reach 09/02/06

Rivers Reach 03/05/05

Rivers Reach 25/11/04

Rivers Reach 04/06/04

Rivers Reach 22/04/04

Rivers Reach 07/05/03

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Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Rivers Reach Fontley Road Titchfield Fareham Hampshire PO15 6QX Lead Inspector Craig Willis Unannounced Inspection 31st May 2006 10:30 Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 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 Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rivers Reach Address Fontley Road Titchfield Fareham Hampshire PO15 6QX 01329 842759 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) staff@riversreach.demon.co.uk Rivers Reach Care Limited Ms Karen Hurt Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th February 2006 Brief Description of the Service: Rivers Reach is registered to provide care and accommodation to five people between the ages of 18 and 65 who have learning disabilities. Each service user has a single bedroom, and shares the use of two bathrooms and two showers. Service users share the use of a lounge, dining room and kitchen. There is an enclosed garden to the rear of the home that service users are able to access. Service users are encouraged to be as independent as possible and to participate in the day-to-day running of the home by helping with shopping, cooking and cleaning. There are opportunities to access day care provision outside the home. The manager provided information to the CSCI on 30/5/06 that the range of fees at the home was from £1800 to £2100 per week, depending on the assessed needs of service users. Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence used to write this report was gained from a review of the information the provider sent to the Commission for Social Care Inspection (CSCI) and a site visit to the home on 31st May 2006. During the site visit the inspector spoke with two of the service users, care staff on duty and the manager. CSCI surveys were returned from four service users and four relatives. A tour of the building was made and the inspector observed the way staff were supporting service users. Documents relating to the running of the home were inspected during the visit. What the service does well: What has improved since the last inspection? The introduction of a maintenance budget for the manager has enabled the manager to fit new flooring in the kitchen and a service user’s bedroom and plan further improvements. Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems to assess the needs of service users before they move into the home. EVIDENCE: The files of three service users were inspected during the visit. Each contained an assessment of their needs that was completed before they moved into the home. This assessment covers the individual needs of service users, including communication and personal care needs. No new service users have moved into the home since the last inspection. Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had good care planning and risk assessment systems, which supports service users to make decisions about their lives and take managed risks. EVIDENCE: The personal files of three service users were inspected during the visit. Each service user had a care plan that was developed from their initial needs assessment. These plans are reviewed monthly and had been changed where the needs of the service user had changed. Person centred “essential lifestyle plans” had also been completed by each service user, which set out their preferences and wishes. Service users spoken with said they were aware of what was in their care plans and confirmed that they were involved in their review. Care plans contain details of how service users should be supported to make decisions. Evidence was seen of the involvement of a local advocacy service to support one service user to make decisions about their residency agreement. Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 10 Risk assessments were in place for all three service users whose files were inspected. These documents set out the assessed hazards to service users and action to minimise the risk of harm. The risk assessments had been reviewed every six months, or more frequently if necessary. The manager reported that the care plans and risk assessments will be transferred into a new format that is used by the new owner of the company in their other care homes. Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good support for service users to take part in suitable activities, to maintain relationships with family and friends and provides good food. Service users rights are respected, although this would be improved by the provision of keys to service users so they can lock their bedrooms. EVIDENCE: Service users are supported to take part in a range of educational and leisure activities. Service users spoken with said they attend a local college to do courses in cooking and arts and crafts and like to go to local pubs, cinema and theatre. Service users’ files contained details of activities they had taken part in, including archery, horse riding and caving. Service users are supported to keep in touch with family and friends, with one service user’s plan giving details of support that is required to write letters. One family member responding to the CSCI survey said that support was provided to enable the service user to visit the family home. Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 12 Service users spoken with said that staff maintain their privacy and treat them well. Locks are fitted to all bedroom doors, although some service users do not have the key. The manager agreed to ensure that keys were provided to service users by the end of July 2006, so that they could lock their door when they go out. Service users spoken with said they would like a key to their bedroom door. Details of the support service users need to complete household jobs, such as cleaning and cooking, are detailed in their care plans. The home has a planned menu that takes into account the likes and dislikes of service users and provides a varied and balanced diet. Support is provided for one service user to follow a specific diet due to diabetes. Service users spoken with said the food was good and they could always have something different if they wanted to. Mealtimes are flexible to fit in with service users’ activities. The kitchen was well stocked with a variety of good quality food. Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good support to meet the personal care and health needs of service users. The medication systems in the home are good and protect service users. EVIDENCE: Details of the personal care support service users need are set out in their care plans. Service users spoken with said that staff provided support in the way they wanted it and treated them well. All four service users responding to a CSCI survey said staff treated them well and listened to them. Records are maintained of service users’ visits to health services, including GP, dentist, optician, chiropodist, anger management therapist and psychiatrist. The records kept included details of any advice given by the practitioner. Service users spoken said they were supported to see their doctor when they needed to. All four service users responding to a CSCI survey said they were able to see a doctor and dentist when they wanted to. Medication was stored in a locked cabinet in the office and medication administration records had been fully completed. All staff administering medication have undertaken training and staff are currently in the process of completing an in-depth twelve week medication course through a local college. Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 14 The pharmacist visits the home every six months to assess the storage and administration procedures. Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident their complaints will be taken seriously and acted upon and the home has good adult protection systems, which help to keep service users safe. EVIDENCE: The home has a complaints procedure available, which sets out who will deal with a complaint and how long the provider will take to respond to a complaint. The procedure has been supplied to all service users in an accessible pictorial format. Service users spoken with said they know what to do if they want to make a complaint and were confident that it would be taken seriously. Three of the four relatives responding to a CSCI survey said they are aware of the home’s complaints procedures. All four service users who responded to a CSCI survey said they know who to tell if they are unhappy. No complaints have been received since the last inspection. The home has an adult protection policy and a copy of the local authority adult protection procedures. Staff have received adult protection training and those spoken with demonstrated a good understanding of abuse and action to take if abuse was reported or suspected. Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and provides a safe, homely environment for service users. EVIDENCE: A tour of the communal areas of the home was made during the visit. The home is well maintained and decorated throughout. Furnishings were domestic and of good quality. Service users spoken with said that the home is always clean and that they have sufficient space. The home has an enclosed rear garden, which service users are able to access. The manager reported that the provider has a maintenance team and she has no problem getting work done when it is required. The manager also said that since the company has been taken over, she has been given a budget for maintaining the building and has recently fitted new floor covering in the kitchen and a service user’s bedroom and new curtains in the dining room. The home has a separate laundry room, which is accessed through the kitchen. There are infection control procedures in place to prevent laundry being taken through the kitchen whilst food is being prepared or eaten. There are hand washing facilities in the kitchen, laundry room, bathrooms and toilets. Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good systems to protect service users and meet their needs through the staff training programme and recruitment procedures. EVIDENCE: The manager reported that six of the fifteen staff employed have achieved the National Vocational Qualification (NVQ) at level two or above, including two staff who work at night. Four staff are currently working towards the qualification. During the visit, staff were observed interacting with service users in a friendly and respectful manner. The manager reported that no new staff have been employed since the last inspection in February 2006. The recruitment records of the two most recently recruited staff were inspected. For both members of staff to home had obtained two written references and had checked whether they were on a list of people assessed and unsuitable to work in care homes. The home had only received an enhanced Criminal Records Bureau disclosure for one of these staff. The other disclosure had been applied for before the person started work and they were supervised at all times whilst at work. The manager reported that she is following this delay up with the Criminal Records Bureau. Staff spoken with said that they received very good training and could not think of things they needed training in that were not available. A record is kept of all training that staff have undertaken and staff appraisals include a training needs assessment. Staff complete an induction based on the Skills for Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 18 Care criteria. Courses staff have completed include first aid, medication administration, food hygiene, fire safety, health and safety, infection control, adult protection, autism, challenging behaviour, diabetes and bi-polar disorder. Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a competent manager who takes action to promote the health, safety and welfare of service users and staff. The completion of the home’s quality assurance audit and provision of formal supervision for the manager will help to ensure the service continues to improve. EVIDENCE: The manager has completed an NVQ level 4 in Health and Social Care and is currently completing the Registered Manager’s Award. The manager is also a qualified NVQ assessor. The manager said she receives good support from the senior management staff and is able to speak with them whenever she needs to, although she has not had formal supervision meetings. The home has sent out questionnaires to service users, visitors and staff to gain their views of the quality of the service that is being provided. The manager said she was expecting this information to be collated and used to create an annual development plan, although this had not yet happened. All Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 20 four service users who responded to a CSCI survey said that the home has meetings to talk about what is good at the home and what should be changed. Senior managers form the providers visit the home each month to review the service quality. Reports of these visits contain actions that are required to improve the service. Since new providers have taken over the service, the CSCI has only received one of the three reports completed. The manager said she would ensure future reports are sent to the CSCI. The home has a fire risk assessment and regular checks are made of the fire warning system and the equipment. The oil fired boiler is serviced annually and annual tests of portable electrical appliances are completed. Assessments are completed for chemicals used in the home, which are stored in a locked cupboard. The temperatures of the fridge and freezer are taken daily and recorded. Accidents and incidents to service users and staff are recorded and reported where necessary. Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Rivers Reach DS0000011923.V291013.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!