Inspection on 22/08/05 for Riverside Court

This inspection was carried out on 22nd August 2005.

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

The inspector 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

Riverside Court 25/08/09

Riverside Court 04/06/08

Riverside Court 21/11/07

Riverside Court 20/08/07

Riverside Court 27/02/07

Riverside Court 15/05/06

Riverside Court 09/12/05

Riverside Court 26/11/04

Riverside Court 01/06/04

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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 RIVERSIDE COURT The Croft Knottingley WF11 9BL Lead Inspector Mavis Pickard Unannounced 22 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Riverside Court Address The Croft Knottingley WF11 9BL Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01977 673233 01905 795095 Speciality Care (Rest Homes) Limited Ms Julie Douce Care Home with Nursing 61 Category(ies) of Older People - over 65 years - 31 registration, with number Dementia - over 65 years - 30 of places Mental Disorder - over 65 years - 30 Dementia - 18-65 years - 1 Mental Disorder - 18-65 years - 1 RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Conditions of this registration are listed on the registration certificate displayed at the service. Date of last inspection 26/11/04 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 care and a 30-bedded unit providing nursing care for the elderly mentally ill [dementia care]. 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 carparking facilities at the front of the premises. RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was undertaken by two Inspectors over a 6-hour period and concentrated on that part of the home providing general nursing care to people over 65 years of age. The nursing units, Trent and Avon, are situated over 2 floors. On the day of inspection, Trent was home to 15 people and Avon home to 7 people. The home’s general services such as laundry, kitchen and domestic services the way in which medication is handled, record keeping, recruitment and complaints were looked at across the 4 units that make up Riverside Court. What the service does well: What has improved since the last inspection? What they could do better: Concerns were raised with the registered manager about the general cleanliness of Trent and Avon units and about some aspects of the care provided to individual residents. The general environment could be cleaner and fresher. The kitchen could be cleaner and would benefit from deep cleaning. The recording and handling of medications could be more systematic. Staff at all levels could be more directly and robustly supervised. Please contact the provider for advice of actions taken in response to this RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3 & 6 All residents have the information they need to choose to be admitted to the home and all newly admitted residents have been appropriately assessed. The home does not admit residents for intermediate care. EVIDENCE: From records examined and from speaking with the manager it is clear that, although not all residents admitted in the past have written pre-assessment records, all people recently admitted have been admitted following a comprehensive written assessment of their needs. The home does not provide an intermediate care service. RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 9 Not all care plans are followed. Not all residents have their care needs fully met. Not all medication records are accurate. Medication was not being administered according to the directions of all individual resident’s GP. EVIDENCE: Inspectors examined the care plans of several residents. Not all care plans were being followed. Inspectors observed several care plans indicating that pressure area care is required. However, records maintained in residents’ bedrooms do not show clearly the way that pressure care is being delivered. Turning charts do not record clearly the action taken and what condition the skin was in at each turn. Not all records were signed and dated. [Please refer to Standard 16] One turning chart was titled as ’fluid balance chart’ and only gave information about elimination. It was noted that other charts intended to record ‘turns’ were, in reality, elimination charts. A risk assessment in respect to a resident’s nutritional assessment undertaken in June 2004 and reviewed in February 2005 stated that the resident required a soft diet and was at risk from choking. RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 10 The resident said that they had been given a lunch of sandwiches whilst lying down on bed rest. This was brought to the attention of the registered manager who said that the resident was not now at risk of choking and that this fact is now recorded in the resident’s progress notes. The resident’s care plan and/or nutritional risk assessment had not been reviewed or amended. As part of the inspection, medication procedures for Trent and Avon units were examined. The home, which uses a monitored dosage system supplied by a local pharmacy, was on the 4th day of a 28-day cycle of medication. It was noted that a resident had not received their medication for day 3 of the cycle; the reason recorded is that they were sleeping. There were further medication errors that were brought to the attention of the registered manager. RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 Not all residents receive a nutritious balanced diet. EVIDENCE: The home has a system whereby the main meal of the day is taken at 4.30pm. Therefore, lunch is a choice of a lighter cooked meal or sandwiches. Inspectors examined the written menu; they appeared to provide a nutritious and well balanced diet. However, the cook said that, on the day of inspection, she was unable to provide the meal stated on the menu as the ingredients were not available. Residents spoken to said that they had eaten a sandwich for lunch, staff said that this had been the case and that the residents concerned had been provided with toast and marmalade for breakfast and that the most recent hot meal would have been at 4pm the previous day. This issue was brought to the attention of the registered manager. Individual records of the food taken by residents were unavailable for inspection. Inspectors examined nutritional assessments for residents; not all were being followed. The registered manager was alerted to this situation. [Please refer to Standards 7-11] RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Not all residents and/or their relatives are confident that their complaints will be investigated thoroughly. EVIDENCE: Since the previous inspection, the Commission has investigated a complaint that, although referred through the home’s complaints procedure by the complainant, was not investigated to their satisfaction. The following shows the area of complaint and the Commission’s findings. 1. Pressure care management 2. Hydration 3.Acts of neglect and/or omission. Requirements made are: That individual care plans designed to record skin viability must be maintained for all residents where waterlow assessments indicate a high risk of skin breakdown, and that these records are reviewed regularly and kept up to date. That a dietary/fluid chart is kept when concerns are raised about an individual’s dietary/fluid intake. RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 13 Upheld Upheld Not upheld It was recommended that: A body map is maintained for individuals transferred to hospital, a copy of which is transferred with the resident when admitted. A family member or representative [designated N.O.K] is informed when their relative is referred to a GP and/or when their condition deteriorates or gives cause for concern. Records examined during the investigation show that the home had alerted a GP when the resident began refusing food and fluids and had subsequently followed the GP advice. Records of dietary/fluid intake or refusal for the resident were not made available for the purpose of the investigation. The complainant stated in feedback that they are satisfied with the findings of the complaint investigation. RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,21,22,24 & 26 Not all areas of the home are safe from intruders. Residents are provided with sufficient bathing and toilet areas. In the main, residents’ bedrooms are appropriate and they have their own possessions around them. Not all private and communal areas of the home are clean. EVIDENCE: Inspectors arriving at the home observed that the main door was being held ajar by an ashtray. This is concerning as it leaves the home and residents vulnerable to unwelcome visitors. The registered manager explained that her instructions that the door should be closed are not always followed. It was observed that not all wheelchairs being used to transport residents were fitted with footrests. During a tour of Avon and Trent units, inspectors observed that, in general, the décor is satisfactory and residents have personalised their rooms. Some bedrooms would benefit from minor maintenance improvements. RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 15 Concerns were raised with the registered manager that, in one bedroom, a newly fitted magnetic door closure has been ‘torn’ from its anchor. A cushion placed near the door indicated to Inspectors that the resident might be using this to keep her door ajar until the magnetic closure is repaired. Magnetic door closures were fitted to satisfy a recent fire safety inspection where the fire officer became aware that residents and/or staff were wedging open fire resistant doors to occupied rooms. Some residents’ bedrooms were pleasant and clean and showed that they had been personalised. There were some bedrooms that were not clean. The manager, whose attention was alerted to a bedroom that was in an unhygienic condition, said that she was aware of the situation and that the resident refuses to allow domestic staff in to clean the room. Inspectors consider that the manager must find a way of effectively managing this situation for the benefit of all people accommodated. Inspectors visited the laundry area that is much improved since the last visit. The kitchen was also visited; the lack of cleanliness in this area was brought to the attention of the registered manager who said that she is aware that the kitchen requires a thorough cleaning. An Environmental Health Officer [EHO] report of May 2005 made some minor recommendations. Following the CSCI inspection, the EHO was contacted who said, in her opinion, generally there are no concerns about the cleanliness of the kitchen at Riverside Court. RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 30 The numbers and/or skills of staff on duty were not meeting all current resident needs. EVIDENCE: The manager said that sufficient staff were working in the home during this visit. Inspectors raised their concerns about a lack of support for people who were taking meals in their rooms. Although staff were noted to be going about their duties in a pleasant way, inspectors were concerned that there was no clear evidence that care staff were being supervised by senior staff on duty, with respect to their work with residents. There was little evidence that social interaction was taking place between staff and residents. Residents were observed to be spending long periods alone in their bedrooms. With reference to standard 30, the home in general is not clean, it was not clear that this is because of the lack of domestic hours available or the lack of training/supervision of domestic staff. RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 & 38 Not all staff are appropriately supervised. Safety equipment is not always used and/or maintained. EVIDENCE: Inspectors did not inspect the supervision records of staff. However, the general day-to-day supervision of care staff was discussed with the registered manager. Inspectors saw evidence that, although the home employs a housekeeper who directly supervisors the domestic staff, many areas of the home were not clean or free from offensive odours. The home employs maintenance staff who are directly supervised by the registered manager, however inspectors brought to the attention of the manager, areas of the home that required to be maintained appropriately. Since the inspection the manager has said that cleanliness and maintenance issues are being dealt with as a matter of urgency. RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 18 The registered manager said that it is the intention of the organisation to ensure the health and safety of service users and staff. However, inspectors consider the health and safety concerns discussed in this report and with the registered manager could compromise the overall health and safety of service users and staff. RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 1 COMPLAINTS AND PROTECTION 1 x 3 1 x 3 x 1 STAFFING Standard No Score 27 1 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 x x x x x x x 1 x 1 RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 20 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 12(1)(a) 15 (2)(b) 17(1)(a) Schedule (3)(n) Requirement That written care plans must be reviewed regularly and followed. That pressure area care where indicated as necessary by the care plan/waterlow assessment must be actioned, recorded clearly and reviewed on a continuing basis. That staff must adhere to the GP instructions for the admisitration of medication. An accurate record must be maintained of the administration of medication to residents. A record of the food provided for residents must be maintained in sufficient detail to allow that any person inspecting the record can determine whether the diet is satisfactory. Staff must be ready to offer assistance with feeding where necessary Timescale for action with immediate effect [22/8/05 with immediate effect [22/8/05] with immediate effect [22/8/05] with immediate effect [22/8/05] with immediate effect [22/8/05] with immediate effectwith immediate effect [22/8/05] with Page 21 2. 8 3. 9 4. 9 12(1)(a) (b) 13(1)(b) 13(2) 17(1)(a) Schedule (3)(i) Schedule 4(13) 5. 15 6. 15 12(1) 7. 16 The registered person must J51J01_S6212_Riverside Court_V224630_240805.doc RIVERSIDE COURT Version 1.40 ensure that all complaints are fuly investigated 8. 19 23(4) (c)(i) The registered person must make adequate arrangements for the containment of any fire. immediate effectwith immediate effect [22/8/05] with immediate effectwith immediate effect [22/8/05] with immediate effectwith immediate effect [22/8/05] with immediate effectwith immediate effect [22/8/05] with immediate effectwith immediate effect [22/8/05] with immediate effectwith immediate effect [22/8/05] with immediate effectwith immediate effect [22/8/05] 9. 22 23(2)(c) Footrests designed to be fitted to wheelchairs when used by residents must be so fitted where this is appropriate to the residents need. The home must be kept clean throughout. 10. 26 12(1)(a)1 6(2)(j) & (k) 11. 27 18(1)(a) The registered person must ensure that at all times staff numbers and the skill mix of people working in the home meets the assessed needs of residents. Staff working in the home must be approprietly supervised in the role they perform. 12. 36 18(1)( c) (i) 18(2) 13. 38 13(4)(c) The registered person must ensure the security of the premises. RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 22 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 Good Practice Recommendations RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 Page 23 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 RIVERSIDE COURT J51J01_S6212_Riverside Court_V224630_240805.doc Version 1.40 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. 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