Inspection on 09/12/05 for Riverside Court

This inspection was carried out on 9th December 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 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 21/11/07

Riverside Court 20/08/07

Riverside Court 27/02/07

Riverside Court 15/05/06

Riverside Court 22/08/05

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 West Yorks WF11 9BL Lead Inspector Gillian Walsh, Pat Pedley and Tony Brindle Unannounced Inspection 9th December 2005 02:30 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.V272779.R01.S.doc Version 5.0 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.V272779.R01.S.doc Version 5.0 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 riversidecourt@craegmoor.co.uk Speciality Care (Rest Homes) Limited Ms Julie Douce 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.V272779.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. One place DE for named person Date of last inspection 22nd August 2005 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 car parking facilities at the front of the premises. Riverside Court DS0000006212.V272779.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken by three inspectors on 9 December 2005. Time was spent speaking to residents, staff and the manager, walking around the home to assess the environment and reviewing documentation. Inspectors would like to thank residents and staff for their time and assistance. What the service does well: What has improved since the last inspection? What they could do better: Improvements are required in relation to the assessment and care planning processes at the home, the arrangement of appropriate professional intervention to meet residents’ needs, procedures and care practices to maintain the dignity of residents and the provision of suitable recreational and social activities. Procedures with regard to medication are poor and improvements are needed with regard to the provision of meals to residents. Riverside Court DS0000006212.V272779.R01.S.doc Version 5.0 Page 6 The manager needs to ensure that correct procedures are followed in relation to the protection of vulnerable adults and staff training and other procedures in relation to fire safety need to be improved. Improvements are needed to the environment and in the maintenance of hygiene within the home. 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. Riverside Court DS0000006212.V272779.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Riverside Court DS0000006212.V272779.R01.S.doc Version 5.0 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 the following standard(s): None of the above standards were assessed on this occasion. EVIDENCE: Standards 1, 3 and 6 were fully assessed at the last inspection and all found to be satisfactory. Riverside Court DS0000006212.V272779.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9 and 10 Care plans do not fully reflect residents’ needs. Not all residents’ health care needs are fully met. Residents are not protected by the home’s procedures for dealing with medicines. Residents’ dignity needs are not always met. EVIDENCE: A selection of care plan files from both units of the home were examined. One of the care plans for a resident who is blind did not contain any reference to their visual problems or give any indication of any involvement from visual impairment workers or the blind/partially sighted society. Another resident’s file did not contain any care plans for pressure sores despite it being written in the evaluation of the skin integrity care plan that the person had pressure sores to the hip and foot. Another resident who had severe difficulties with speech did not have a care plan in this regard and there was no evidence to suggest that a referral had been made to the speech therapist or any other Riverside Court DS0000006212.V272779.R01.S.doc Version 5.0 Page 10 professional who may be able to assist with communication. None of the care plan files seen contained relevant and detailed plans of care for social or diversional activity. Daily records were very brief and did not relate to care plans. One care plan stated that the resident was at risk of weight loss but detail of food or fluid intake was not recorded in daily records. Several care plans and assessments were in need of evaluation and redevelopment. Two fluid charts were seen in residents’ bedrooms which did not show that those residents had been given drinks over the last few hours. One of the staff said that residents had been given drinks but the chart had probably not been completed. Other fluid charts showed better records. One pressure care chart in a resident’s room had no entries for that date at 11.30am. On examining the medication records, there were a few gaps where medication had not been recorded as having been administered. Also, there were times when staff had not recorded the medication as being received onto the medication administration record sheets. A number of un-named strips of medication, which were not in the appropriate boxes, were found in one medication trolley. The nurse in charge said he could not be sure which resident they belonged to. It was also noticed, and confirmed by the nurse in charge, that lactulose was being dispensed to several different residents from the same bottle. Two staff were seen entering the nursing unit lounge to assist a resident to move using a hoist. Until they were conscious of the inspector’s presence, they did not speak with the resident at all. They then went on to talk to the resident a little. Upon lifting the resident in the hoist, the resident’s skirt was hanging loose which meant that other people in the room could see her undergarments. One resident, who could be seen from the corridor, was in bed in their room. The resident was not wearing any pyjama bottoms and their underwear and incontinence pad were in full view. Some fluid balance, pressure area care and bathing charts were seen in the residents’ lounge. At teatime, one care assistant was observed to be feeding two residents with their meal at the same time. Riverside Court DS0000006212.V272779.R01.S.doc Version 5.0 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 the following standard(s): 12 and 15. Residents’ recreational and social needs are not assessed and met appropriately. Not all meals served to residents are appealing and are not always served in pleasant surroundings. EVIDENCE: When first visiting the upstairs EMI unit, three members of staff were sitting with residents. They said this was a quiet period before “getting residents toileted before lunch”. Staff were asked if they carried out activities with residents. They said that some residents liked to listen to music, dance or sing. The activity organiser said there was usually more going on in the way of activities but they were getting ready for Christmas and so it was quieter than normal. The manager said that several residents had enjoyed a meal out at a hotel in Pontefract and other residents were going to a party at the nearby parish rooms soon. Several residents were seen sitting alone in their rooms with little or no stimulation. One resident was seen sitting in a small chair which was holding the bedroom door open throughout the visit. This resident was also observed to be given their meal in this position. One staff member said that this was Riverside Court DS0000006212.V272779.R01.S.doc Version 5.0 Page 12 because this person’s behaviour was disruptive and another said it was because they would not enter the dining room. Another resident who was alone in their room said that they got very bored; this person had a sensory impairment but no evidence was available to suggest that any advice on suitable activity or stimulation had been sought. One resident on the EMI unit was seen lying on another resident’s bed and, although staff were aware of this, no effort was made to take the resident to their own room. Some of the residents spoken with said that they enjoyed the food provided to them at the home and appeared to be happy with the new system of having the main meal of the day at teatime. The cook was asked if residents had a choice of food. She said that they have a choice from the menu but that residents are not asked before the meal is served what they would like, therefore there are few alternatives on offer. She said that she makes sufficient of each menu choice on the day so that residents can choose from the two options. Although menus are kept in the kitchen, the cook said that she sometimes makes alternatives to the menu. No record was available of food provided to residents although this was made a requirement in the previous report. At the lunchtime meal, residents who needed a soft diet were being provided with a dish of food, which was not easily identifiable. Care staff said that it was soup that had had bread put in it whilst being cooked and before being liquidised. This meal looked unappetising and it was recommended to the manager that advice be sought from the dietician about appropriate foods and food preparation for people with swallowing difficulties. Dining rooms, particularly on the EMI unit, are in need of refurbishment and redecoration. This is further described in the environment section of this report. Riverside Court DS0000006212.V272779.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 16 and 18. Complaints are dealt with appropriately. Procedures for protecting residents from abuse are not being followed. EVIDENCE: A record was seen of complaints received. These had been attended to. Discussion took place about recording minor complaints too since this will help the home to demonstrate that they listen to service users and change ways of working for the benefit of residents. An examination of accident records showed that an incident of assault had occurred between two service users but no record was available that this had been reported to the appropriate authorities. Staff at Pontefract General hospital had made a referral to Wakefield’s adult protection team regarding the care of one resident who had been admitted to the hospital from Riverside Court. This case was ongoing at the time of the inspection. Discussion took place with the manager about the need to address such incidents through the local authority’s vulnerable adult procedures and informing the Commission of such incidents through Regulation 37 notifications. Riverside Court DS0000006212.V272779.R01.S.doc Version 5.0 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 the following standard(s): 19, 20 and 26. The environment is not cleaned and maintained to a level which would maintain residents’ safety. EVIDENCE: From walking around the home, many areas were found to be in need of a deep clean, particularly carpets on corridors and in some bedrooms. Some toilets were badly marked and needed cleaning. Toilet seats were in need of replacement in several en-suites. Bath sides were broken in some bathrooms and could cause injury to residents using these facilities. The visitor’s toilet had the door handle missing. The manager said that this could not be repaired and was awaiting the door being replaced. The door of one en-suite on the lower EMI unit had dropped at the hinge and could not be opened or closed without sticking on the carpet. Riverside Court DS0000006212.V272779.R01.S.doc Version 5.0 Page 15 Dining room furniture on the EMI unit was in need of re-varnishing or replacement and dining chairs also needed the seats cleaning. The manager said that the company had agreed to replace chairs and dining room flooring. Dining rooms on the EMI unit were also in need of redecoration. Tablecloths on the EMI unit were seen to be frayed around the edge and need to be replaced. Containers used for juice were in need of a thorough wash as it looked as though these had been refilled on several occasions. The home’s main kitchen was visited. The cook said that she was short staffed for the week of this inspection. Normally they follow a cleaning schedule. The record of cleaning was seen and it was found that some areas within the kitchen had not been cleaned in accordance with the schedule for nearly three weeks. The cook said this was unusual. A look around the kitchen found that the fridge and freezers were dirty and the deep fat fryers had scum around the edge of the oil. The cook said these were being cleaned that afternoon. The kitchen floor and cookers were also in need of thorough cleaning. The small kitchen on the EMI unit was not clean with food spillages on the floor and down the walls. Crockery ready for use was unclean and feeding cups and teapots were badly stained and in need of replacement. A brush used for sweeping the floor was very dirty and thick with grease. Cutlery and food containers were also dirty. Oven gloves used to take food from the hot trolley were dirty and the sponges used for washing up were very dirty with bits of old food stuck to them. Several wheelchairs were seen to have no footplates or only one footplate. One resident was being pushed around the home without their feet being positioned on the footplate properly. Several bedrooms were seen to have no call bell lead. Clinical waste bins were seen to be overflowing and unlocked. Doors throughout the home were held open with doorstops or furniture. In the event of a fire, this practice would prevent the containment of smoke and fire. Riverside Court DS0000006212.V272779.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 and 30. The home’s recruitment policies protect residents. Staff training is in place but documentation needs to be better organised to evidence this. EVIDENCE: Staff records examined were found to be satisfactory. The home has retained a large number of criminal record bureau disclosures, including those for staff who have left the home’s employ. Discussion took place with the manager about disposal of these confidential records. From examining staff records, it was difficult to ascertain what training staff had completed although many certificates were in place. Clearly, training is taking place. However, staff records were not individualised for an effective judgement to be made. A graph of staff training was shown but the writing was so small that it was difficult to read. The manager said that this was the graph used by the company. The graph did not include training dates. Discussion took place about how this information could be more clearly presented for future inspections. Riverside Court DS0000006212.V272779.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 The health, safety and welfare of residents and staff are put at risk through poor procedures with regard to fire training and safety issues. EVIDENCE: The records of supervision were seen for seven members of staff. These demonstrated that those staff received regular supervision. An examination of the home’s maintenance files found that up to date certificates were not available. On giving feedback to the manager later in the day, she said that she had provided the wrong file for inspection. She was asked to forward up to date certificates for gas safety, fire alarms and emergency lighting, water chlorination, passenger lift and hoists to the Commission. Riverside Court DS0000006212.V272779.R01.S.doc Version 5.0 Page 18 The records of fire drills demonstrated that such drills were not carried out on a regular basis. Staff training records did not show that staff have had two fire lectures within a twelve month period. The linen cupboard was found to be open, this was marked as a fire door to be kept locked. During the inspection, the fire alarms were being serviced. The alarm was sounded and automated doors closed. The door in the upstairs EMI lounge did not close into the rebate. A recent fire risk assessment carried out by an external agency also highlighted this with some doors and some other work needed. The manager was asked to attend to these faults and report to the Commission once completed. The record of temperatures in the kitchen were found to be up to date. Riverside Court DS0000006212.V272779.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 X 14 X 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 1 1 X X X X X 1 STAFFING Standard No Score 27 X 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 1 Riverside Court DS0000006212.V272779.R01.S.doc Version 5.0 Page 20 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 That written care plans must be completed to cover all areas of need, reviewed regularly and followed. Daily records should also reflect, in detail, the general condition of the resident and any care they have received. The registered person shall make arrangements for service users to receive, where necessary, treatment, advice and other services from any health care professional. The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home by the date shown and continuing thereafter. The registered person shall make suitable arrangements to ensure that the care home is conducted in a manner, which respects the privacy and dignity of service users. The registered person must make arrangements for DS0000006212.V272779.R01.S.doc Timescale for action 31/01/06 2. OP8 13(1)(b) 31/01/06 3. OP9 13(2) 09/12/05 4. OP10 12(4)(a) 31/01/06 5 OP12 16(m)(n) 31/01/06 Riverside Court Version 5.0 Page 21 6 OP15 Sch 4(13) 7 8 OP15 OP18 12(1) 13(6) 9 10 11. OP19OP38 OP20 OP26 23(4)(c)(i ) 23(2)(b) 12(1a)16( 2j&k) 23(d) resident’s social and recreational needs to be assessed and met appropriately. 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. Advice should be sought about appropriate food for residents with swallowing difficulties. Staff must be available to offer appropriate assistance with feeding where necessary The registered person shall make arrangements, by training staff or other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. Local policies and procedures for dealing with potential or actual abuse must be followed. The registered person must make adequate arrangements for the containment of any fire. The premises must be kept in a good state of repair. The home must be kept clean throughout. 31/01/06 31/01/06 31/01/06 31/01/06 31/01/06 22/08/05 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 OP8 OP29 Good Practice Recommendations When in use, fluid balance and pressure area care charts should be filled in timely and appropriately. CRB reports should be destroyed after being seen by inspectors from the Commission. DS0000006212.V272779.R01.S.doc Version 5.0 Page 22 Riverside Court 3 OP30 Records relating to staff training need to be better organised. Riverside Court DS0000006212.V272779.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Brighouse Area Office 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 DS0000006212.V272779.R01.S.doc Version 5.0 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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