Inspection on 21/11/07 for Riverside Court

This inspection was carried out on 21st November 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Riverside Court 25/08/09

Riverside Court 04/06/08

Riverside Court 20/08/07

Riverside Court 27/02/07

Riverside Court 15/05/06

Riverside Court 09/12/05

Riverside Court 22/08/05

Riverside Court 26/11/04

Riverside Court 01/06/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Riverside Court The Croft Knottingley West Yorks WF11 9BL Lead Inspector Gillian Walsh Key Unannounced Inspection 10:00 21 & 22 November 2007 st nd 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 Riverside Court DS0000006212.V355410.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. Riverside Court DS0000006212.V355410.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Riverside Court Address The Croft Knottingley West Yorks WF11 9BL 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) 01977 673233 01977 673066 riverside.court@craegmoor.co.uk Speciality Care (UK Lease Homes) Limited Care Home 61 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (30), Mental disorder, excluding learning of places disability or dementia (1), Mental Disorder, excluding learning disability or dementia - over 65 years of age (30), Old age, not falling within any other category (31) Riverside Court DS0000006212.V355410.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One place DE for named person Date of last inspection 20th August 2007 Brief Description of the Service: Riverside Court is a purpose built home which provides nursing care for up to 61 older people. The home is divided into two separate nursing units: a 31bedded unit providing general nursing and residential care and a 30-bedded unit providing nursing and residential care for the elderly people living with dementia. Accommodation in each unit is located on two floors consisting of single en-suite bedrooms, communal sitting rooms and dining facilities for each unit. There is level access at the main entrance and a passenger lift allows easy access to the first floor accommodation. Riverside Court is situated in the Knottingley district of Wakefield. It is served by local rail and bus routes and has off-street car parking facilities at the front of the premises and a garden to the rear. As of November 2007, fees ranged from £380 to £510 per week, dependent upon the assessed individual need. Additional charges are made for hairdressing, private chiropody and any personal newspapers or periodicals. The home has a Service User Guide that provides information about their service for current and prospective residents. Details of the Commission for Social Care Inspection are included within the Service User Guide Riverside Court DS0000006212.V355410.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Riverside Court has a history of unsatisfactory care standards. Previous inspections identified a number of areas of serious concern. In view of this and within the CSCI regional improvement strategy, three meetings with the company’s Responsible Individual and managers have been held. These meetings focused upon the breaches in regulation, outstanding requirements and sought information from the company regarding progress in these matters, and to obtain an agreement from the company in relation to any outstanding matters. Additional contact has been made with the responsible individual by telephone and at multi agency safeguarding meetings. It was, therefore, of concern to find that many of these matters have not been resolved and the Commission will again formally address these with the company. Since the registered manager resigned in the spring of 2007 there have been several changes of acting managers, the last three being suspended or dismissed by the company following issues of concern. Since the visit in November 2007 a new acting manager has been appointed. Since the last inspection the company has provided the Commission with weekly updates of the progress made in relation to outstanding requirements and their own action plan for improvement in standards at the home. However the findings of this visit were that these updates fail to give a true picture of the home and the poor quality of care provided to people. An unannounced visit was made to the home by two inspectors on 21 and 22 November 2007. On the first day the inspectors arrived at the home at 10:00 hours and left the home at approximately 19:00 hours and on the second day the inspectors arrived at 10:00 hours and again left at approximately 19:00 hours. During this visit, the inspectors spoke to some of the people living at the home, some of the staff and the home’s management. The inspectors read care records, checked a sample of medications, looked at some staff records, walked around all areas of the home and observed lunch being served on one unit. On this occasion surveys were not sent out to gain the views of people involved with the home as this was done prior to the inspection in August 2007. However there was discussion with people and observations of their care throughout both days of the visit. Other information used in the inspection process included notifications from the provider to the Commission for Social Care Inspection about deaths, illnesses, accidents and incidents at the home, copies of the monthly Riverside Court DS0000006212.V355410.R01.S.doc Version 5.2 Page 6 management visit reports and weekly action plan updates produced by the provider. During this visit, the inspectors identified a lack of necessary equipment in the home, poor standards of care, lack of social activities, risks to people’s health and wellbeing and a failure to respect people’s privacy and dignity. As a result of this six referrals were made under safeguarding procedures to the local authority and one to the police. Five referrals were made in respect of the lack of care for five people living at the home and one was made in respect of the conduct of a member of staff. The inspectors would like to thank all of the people who gave their time in assisting this inspection. What the service does well: What has improved since the last inspection? What they could do better: Senior managers should know what is happening in the home on a day-to-day basis and what it is like living and working there. This would give them a better understanding of the problems faced by staff and the poor standards of care some people are receiving. They must provide more staff and train and supervise them to give the care people need to enable them to live as comfortably as possibly. A requirement was made on the day of the visit that the registered person must take immediate action to make sure that there are enough staff on duty to meet people’s needs. Senior management and staff must make sure that people have the equipment they need to keep them safe and comfortable. A requirement was made on the day of the visit that the registered person must take immediate action to make sure that people have access to the equipment they need. Riverside Court DS0000006212.V355410.R01.S.doc Version 5.2 Page 7 Staff should learn more about people’s individual needs and treat them with more dignity and respect, they should record their needs and review them regularly so that people get the care they need and in the way they want it. A requirement was made on the day of the visit that the registered person must take immediate action to make sure that the privacy and dignity needs of the people living in the home are met. Additionally five referrals were made to safeguarding in respect of lack of care for people living at the home. Staff must follow proper procedures to make sure that people receive the medication they have been prescribed and that medicines are kept safely in the home. A requirement was made on the day of the visit that the registered person must take immediate action to make sure that people are not put at risk due to poor systems for dealing with medications. Staff must be observant to risks to people’s safety and take actions to keep people safe. A requirement was made on the day of the visit that the registered person must take immediate action to make sure that people living in the home are safe. Staff must keep the home clean and practice good standards of hygiene. 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. Riverside Court DS0000006212.V355410.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 Riverside Court DS0000006212.V355410.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 adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. People usually have an assessment of their health; personal and social care needs before moving into the home. EVIDENCE: This home does not provide intermediate care. The acting manger said that there have not been any new admissions to the home since the last inspection in August 2007. Some discussion took place about one person who had been readmitted to the home, a few days before the inspection, following a stay in hospital. This person needed a pressure relieving mattress and a bed appropriate to their moving and handling needs. Neither were in place. The acting manager said that this person had been Riverside Court DS0000006212.V355410.R01.S.doc Version 5.2 Page 10 returned to the home from hospital without the home being informed. She also confirmed that the equipment needed by this person had been ordered and was due to be delivered the day after the inspection. However this delay meant that for over a week the person had not had the equipment they needed for their comfort and care. New assessments and care plans had not been developed to reflect the changed needs of this person since their return to the home and a body map which had been completed did not give accurate information. The acting manager said that all people wanting to move into the home in the future would have a full assessment of their needs carried out by an appropriately qualified member of the home’s staff and that the home would obtain a copy of other assessments carried out by involved professionals before they confirmed that they could meet the persons needs at the home. Riverside Court DS0000006212.V355410.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 poor quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. People’s health, personal and social and needs are not being met and their dignity is not being respected. EVIDENCE: Following the key inspection in February 2007 the Commission were informed that person centred care plans were being introduced at the home. Some progress has been made but this is very slow and some people’s care plans still fail to reflect current needs and to provide staff with direction on how to meet those needs. One persons care plan and moving and handling assessment gave conflicting information about their abilities and needs. This could potentially put both the person and staff at risk of injury. Two other care plans seen during the visit failed to identify significant healthcare needs including wound care. Riverside Court DS0000006212.V355410.R01.S.doc Version 5.2 Page 12 Two people seen during the visit were not receiving the nutrition and fluids necessary to maintain their health and wellbeing. One person’s intake chart, seen at 3pm indicated that the person, who was reliant on staff to meet all of their needs, had not received any diet or fluids since 9.25am that morning. This person’s mouth was visibly dry and they were showing signs that they were thirsty. Another person had received only a small amount of fluid despite records showing that they had not passed urine for some considerable time. It was of concern that staff had not recognised the possible reasons for this or the need for actions to be taken to meet this person’s comfort and healthcare needs. Immediate action was taken by management staff to ensure the comfort of both these people. During the first day of the visit it was noticed and pointed out to staff, by an inspector, that one persons socks were very tight and causing indentation around the ankle. A member of senior management immediately removed the socks and discovered that the person had open, weeping sores on the toes; this was of particular concern as staff said that the person suffered from diabetes. The nurse in charge was asked to apply a dry dressing and to contact the GP. Several hours later when the inspectors revisited the person, no dressing had been applied to the sores and the person was still complaining of pain. When asked about this the nurse said that they felt it was “overkill” to refer this person to the GP, however a member of the senior management team made sure that this referral was made. Equipment is not always available at the home to meet people’s individual needs. One person was being nursed in bed and another was sitting in an uncomfortable position due to appropriate chairs not being available to them. Another person did not have the equipment they needed to meet their moving and handling and pressure care needs. The regional manager said that this equipment had been ordered. The privacy and dignity of people living in the home is not being maintained. One person was seen sitting in the lounge with their catheter leg bag unsecured and on display. Other people were seen with food spillages on their clothing, some gentlemen had not been shaved and several ladies were not wearing stockings and slippers. On Avon unit one person had been seated at the dining table for their evening meal having just had a shower. The person’s hair had been towel dried and left without combing or styling in any way. In several peoples bedrooms on Shannon unit there was no soap and staff were unable to explain how these people’s hygiene needs had been met that morning, additionally there was no evidence that people living on this unit had been having baths or showers. At the time of the visit the shower room was still being developed and therefore not in use and the bathroom was dirty and being used to store equipment. One person on Shannon unit was observed to be in a distressed state and showing signs of needing the toilet. When asked by a member of senior management to take this person to the toilet, the nurse in charge looked at their watch and said that it was not toileting time yet. Riverside Court DS0000006212.V355410.R01.S.doc Version 5.2 Page 13 There were additional comments made by other staff about a task approach to group toileting times for people, this indicated an institutionalised approach by some staff that was observed to leave people in distress and discomfort and is not acceptable. Systems for management of medications in the home are not safe. Evidence was found that staff are signing for medications but not administering them, staff could not explain whether one person was correctly receiving their prescribed antibiotic therapy, staff are not always using the correct recording codes on MAR (Medication Administration Record) sheets and not all medications are being appropriately recorded as being received into the home. Additionally, an open medication trolley was seen unattended on Shannon unit and lunchtime medications on the general nursing unit were still being administered at three o’clock in the afternoon. This means that people are not receiving their medications at the times they have been prescribed to be taken. Riverside Court DS0000006212.V355410.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. People who use this service experience poor quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. People’s social, cultural, recreational and nutritional needs are not being met. EVIDENCE: The acting manager said that there are no dedicated activities staff employed at the home at the moment although the company is advertising these positions. Arrangements have been made for monthly religious services to be held in the home and the acting manager said that she planned to increase this to provide services for people of different denominations. During the visit, none of the people living at the home were observed being engaged in any form of leisure or recreational activity. On three occasions inspectors raised the issue of televisions and radio’s playing at the same time in the lounges. On one of these occasions the television was playing without sound but the radio was playing loudly. This can be particularly confusing and distressing for people living with dementia. Riverside Court DS0000006212.V355410.R01.S.doc Version 5.2 Page 15 Despite being highlighted at previous inspections, no action had been taken to engage with a person living at the home who, as a result of their illness, now has better understanding when spoken to in their first language, which is not English. Relatives and friends of people living in the home have previously said that there are no restrictions to their visiting and that staff make them feel welcome. No relatives were spoken with during this visit. The lunchtime meal was observed on Shannon unit. Initially one care assistant was in the dining room trying to support seven people all with varying ability but all in need of some support. People had been given bowls of soup, mugs of tea and plates of finger foods, which, due to their dementia, they were mixing up. Nobody was given a choice of soup or the finger foods and the only drink available was tea. Some people were pouring tea into their soup, one person was taking another’s meal, one person was pouring tea on to the floor and another was not eating at all. Some people were trying to eat soup with their fingers and one person who was initially being assisted by the care assistant was left halfway through their meal when the care assistant went to give meals to other people coming into the room. As a result a number of people did not receive adequate diet or nutrition and others were eating their meal cold. Although two other staff were on the unit, they were busy helping other people to the toilet and preparing them for lunch. A large bowl of fruit was on a table in the dining room on Shannon unit, but all of the fruit in the bowl was rotten. This was pointed out by an inspector and the fruit removed. Riverside Court DS0000006212.V355410.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. People who use this service experience Poor quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. Not all people in the home are being protected from harm or abuse. EVIDENCE: The regional manager said that no complaints had been received since the last inspection and that all outstanding complaints had been responded to in line with the company’s complaints procedure. As a result of referrals made, since the last inspection, within local multi agency safeguarding procedures, all staff at the home have received training from a social worker and the police in safeguarding matters. The regional manager felt that this had been well received and was beneficial to the home. However as a result of this inspection six referrals to safeguarding were made by the Commission. Five of these referrals were made in relation to lack of care to people living at the home and one was made in relation to the conduct of a member of staff. Riverside Court DS0000006212.V355410.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 poor quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. The comfort and wellbeing of people living at the home is not promoted due to poor standards of maintenance and cleaning. EVIDENCE: Since the last inspection Shannon unit has undergone some refurbishment that has included new non-slip flooring in the corridors and dining room and some redecoration in communal areas. People living on that unit had moved to another unit whilst the work was completed but had moved back on to Shannon Unit prior to the inspection despite the work not being fully completed. Workmen were still on the unit sealing floors, fitting a shower room and tending to a number of other outstanding snagging jobs which included nails left sticking out of a piece of wood which had been used to repair a door to a communal toilet and presented a hazard to people living on the unit. Riverside Court DS0000006212.V355410.R01.S.doc Version 5.2 Page 18 Workmen’s tools and substances were seen left on corridors posing a risk to people who live on the unit who were walking about. In addition the curtain rails and therefore curtains had not been replaced in the lounge, despite people having being moved back onto the unit several days before. Following discussion with the acting manager these were hung by the second day of the visit. The bathroom on the unit was being used to store equipment. On Avon unit one of the shower rooms had a large hole in the ceiling exposing mouldy pipes. The lagging for the pipes was hanging through the hole. The grate in the room contained a large amount of green slime and a very unpleasant smell was present in the room. Following inspectors raising concerns about people being exposed to these potential hazards a member of management staff immediately cleaned the grate and flooring. A number of chairs and other furniture in bedroom, lounge and dining areas were in a very poor state of repair. One armchair on Trent had a huge rip in the fabric, which staff were covering with sheets. Dining chairs on Shannon had food stuck to the underside of the arms. When a member of cleaning staff was asked to attend to this by management, they replied that it was not the day for cleaning chairs but did start to do this as requested. As the chairs were being cleaned the arm fell off one of them and another was identified by the inspector as being too unsafe and dirty to be used. Standards of cleanliness in several areas of the home was poor, this included kitchens on units and some bathrooms and bedrooms. Riverside Court DS0000006212.V355410.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 poor quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. Appropriately trained and skilled staff are not available in sufficient number to meet the needs of the people living at the home. EVIDENCE: Observations made during the first day of this visit identified a shortfall in staffing. This was particularly evident on Shannon unit where people’s needs in relation to eating and drinking were not being met, and during the evening on Trent unit where a lack of appropriate staffing resulted in one person sitting alone crying, another who was unable to mobilise independently, trying to walk unaided and another person shouting out in distress whilst the three staff on duty were attending to people in bedrooms. Personnel files for four staff were examined. These files indicate that procedures are being followed in relation to recruitment of staff. Riverside Court DS0000006212.V355410.R01.S.doc Version 5.2 Page 20 The acting manager said that staff training is ongoing and that she was confident that staff are receiving the training they need. However observations during the visit were that staff did not appear to have the necessary skills and understanding needed to meet the physical, psychological and social needs of the people living at the home. Riverside Court DS0000006212.V355410.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 Poor quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. Management processes and health and safety measures are not sufficient to protect people from risk. EVIDENCE: Since the last inspection at Riverside Court the then acting manager has been suspended and subsequently resigned. The Business Support Services manager who was said to be supporting the acting manager was also suspended and has since left the company. Craegmoor has appointed a new acting manager who, at the time of the visit was receiving support from another of Craegmoor’s Business Support Services Riverside Court DS0000006212.V355410.R01.S.doc Version 5.2 Page 22 managers. However shortly after the visit the company informed the Commission that this acting manager had also been suspended. Whilst senior managers in the company have in the last year taken action to improve the quality of the staff and management team. It is of concern that there has been a lack of stable and focussed leadership and management within the home that has contributed to the ongoing problems in providing good care. Craegmoor has continued to send the Commission copies of the monthly Regulation 26 reports and weekly updates in respect of the action plan agreed between the Commission and the company, identifying the home has been visited and assessed by a manager with in Craegmoor. However these do not fully reflect the issues seen at the home during this visit and therefore are ineffective. They fail to give a true picture of the home, poor quality of care provided to people. The finances of people living in the home were not assessed during this visit because there was no access to the money, which was held in the safe. A senior member of the management team, present during the visit, advised there had been a problem with the home’s safe and that it had “jammed”. They were waiting for a locksmith to correct this. Since the visit the responsible individual for the company has informed the Commission that the directions of a senior manager to sort out the safe had not been followed by the staff member, this led to the safe not being in use for several weeks. The responsible individual has since confirmed this has been resolved. The health and safety of people in the home and staff is not being maintained. Some of the issues identified included lack of necessary equipment, poor movement and handling practices, wheelchairs being used with mismatching, poorly fitted foot plates, workmen’s tools left on corridors, broken and torn chairs seen throughout the home and people’s care needs were not being addressed by the care staff. Riverside Court DS0000006212.V355410.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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 1 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 2 14 1 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 1 X X X X X X 1 STAFFING Standard No Score 27 1 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 1 X N/A X X 1 Riverside Court DS0000006212.V355410.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES 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)(a) 15(2)(b) Requirement All people using the service must have an up to date, detailed care plan. This will ensure that they receive person centred support that meets their needs. Previous timescales of 31/01/06, 31/07/06, 30/11/06, 10/06/07 and 20/10/07 not met. 2. OP8 13(5) The registered person must ensure that equipment is available to meet people’s health and safety and moving and handling needs. An accurate record must be maintained of the administration of all medication to people who live in the home to be sure they receive the right medication at the right time. Previous timescales of 31/05/07 and 20/9/07 not met. 22/11/07 Timescale for action 31/12/07 3. OP9 13(2) 22/11/07 Riverside Court DS0000006212.V355410.R01.S.doc Version 5.2 Page 25 4. OP10 12(4)(a) The registered person must make sure that the privacy and dignity needs of the people living in the home are met. Previous timescales of 31/01/06, 31/05/06, 31/12/06 and 20/10/07 not met. 22/11/07 5. OP12 16(2)(n)( m) All people living in the home must have access to daily activities which meet their individual needs. The staff must make suitable arrangements to help people maintain their cultural needs. Action must be taken to ensure staff support and assist people properly with their meals and dietary intake. The registered person must make sure that people living at the home are not at risk from suffering harm or abuse. The registered person must make sure that the environment must be kept free from hazards to people’s safety. The registered person must ensure that all repair work required within the home is completed; bedrooms should be in a good state of repair and communal areas decorated and furnished to a good standard. Previous timescale of 20/09/07 not met. The home must be kept clean throughout. Previous timescale of 20/09/07 not met. 31/12/07 6. OP12 12 (4) 31/12/07 7. OP15 12(1) 17/12/07 8. OP18 13(6) 22/11/07 9. OP19 OP38 13(4)(a) 22/11/07 10. OP19 23(2)(b) 31/01/08 11. OP26 12(1a), 16(2j) 23(d) 31/12/07 Riverside Court DS0000006212.V355410.R01.S.doc Version 5.2 Page 26 12. OP27 18(1)(a) Sufficient staff must be on duty within each unit to ensure that all of the individuals’ needs are fully met. Previous timescales of 30/11/06, 31/05/07 and 20/09/07 not met. 22/11/07 13. OP30 12(4)(a) Staff must be trained, supervised 31/01/08 and monitored to ensure people living in the home have their privacy maintained and their dignity upheld. Previous timescale of 20/10/07 not met. 14. OP31 24 (1)(a)(b) The registered person must monitor the day-to-day running of the home and take action when required to ensure the health and welfare needs of individuals are met. Previous timescales of 31/05/07 and 20/10/07 not met. 31/12/07 15. OP33 12, 15 and 24. 13 16. OP38 Effective quality audit systems must be implemented to maintain and monitor standards in the care home. The registered person must ensure that all moving and handling risk assessments are appropriate to the needs of the individual and are conducted by a member of staff who has been appropriately trained to do so. All assessments must contain clear guidance for staff to follow. The registered person must ensure that the moving and handling training staff receive is appropriate and that it is adhered to in their daily work practices. DS0000006212.V355410.R01.S.doc 31/12/07 31/01/08 Riverside Court Version 5.2 Page 27 Previous timescales of 31/05/07 and 20/09/07 not met. 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. 2. Refer to Standard OP3 OP7 Good Practice Recommendations Assessments should be completed for all people re admitted to the home following a stay in hospital. Daily records should evidence that the care plan has been delivered and should contain a detailed account of what each service user has been involved in during the day, and should not just be a generic overview. The registered person should make arrangements for residents’ social and recreational needs to be assessed and met appropriately. Care plans should clearly identify each individual’s interests and hobbies. People should be given choices of activities they would like to participate in and those individuals who are less able to communicate should be given equal opportunities to take part in activities of their choice. 4. OP15 Contents of fruit bowls should be checked daily to make sure that the fruit is fit for eating. 3. OP12 Riverside Court DS0000006212.V355410.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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 Riverside Court DS0000006212.V355410.R01.S.doc Version 5.2 Page 29 - 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. 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