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Inspection on 12/12/07 for Riverside Court Nursing Home

Also see our care home review for Riverside Court Nursing Home for more information

This inspection was carried out on 12th December 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager maintains contact with the local authority and health care trusts. This helps to ensure that the home only accepts people whose needs they can meet. Contact with these groups has also ensured that the home takes the safeguarding of adults very seriously. The manager is familiar with the correct processes and has ensured that all the staff have received training in this subject. The service is working to improve the handling of medication through regular quality checks. Residents are also able to look after and take their own medicines if they wish and are able to.

What has improved since the last inspection?

The care plans of people living at the home have improved greatly and generally reflect their care and support needs accurately. There are some gaps and these have been discussed with the manager. Much work has been done to improve the quality of medicines handling however further improvements are still needed to protect residents from medication errors. Records relating to medication are well kept and clearly show the treatment received by residents, and all medicines could be accounted for. There is minimal use of "when required" sedating medicines and this benefits residents by reducing risks from unnecessary medication. Improvements have been made to the general environment at the home. Many areas have been redecorated with carpets and curtains being replaced too. Housekeeping staff are being provided with training and take pride in their work. This helps to ensure that the home provides a pleasant and comfortable environment for people to live in. Comments were received about the environment with one person stating `that awful smell has diminished noticeably`.

What the care home could do better:

The service must ensure that medicines are given as the doctor intends and that staff follow medication changes accurately so that residents receive safe and effective treatment. The service must also make sure that medicines do not run out. The service must ensure that where nutritional assessments and advice from professionals indicate that further action is needed, including detailed record keeping, that this is carried out. There are some gaps in the risk assessment process, which may place people using this service at risk from harm or injury. Where specialised equipment is in use, the reasons for this must be clearly documented with safe systems of work recorded for staff to refer to. Many of the people living at Riverside Court require assistance from staff (sometimes two members of staff) to meet their care needs and requirements. Consideration should be given to the numbers of staff on duty, the needs and dependency of people living at the service and the lay out of the building.

CARE HOMES FOR OLDER PEOPLE Riverside Court Nursing Home 31 Irish Street Salmoor Way Maryport Cumbria CA15 8AZ Lead Inspector Diane Jinks Unannounced Inspection 12th December 2007 10:30 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 Nursing Home DS0000010105.V351648.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 Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Riverside Court Nursing Home Address 31 Irish Street Salmoor Way Maryport Cumbria CA15 8AZ 01900 815323 01900 815033 riverside.court@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Ltd 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) Mr Daniel Stuart Cleough Care Home 60 Category(ies) of Dementia (30), Old age, not falling within any registration, with number other category (60) of places Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE (maximum number of places: 30) The maximum number of service users who can be accommodated is: 60. Date of last inspection 27th June 2007 Brief Description of the Service: Riverside Court is a purpose built two storey care home providing nursing care to service users within four units. Each of these units can accommodate up to fifteen people. Three of the units are for service users who have been diagnosed as being mentally infirm and the other unit is for older people who do not fall within any other registration category and who require nursing care. Riverside Court is close to Maryport harbour and local amenities. There is a large car park within the grounds of the home and an enclosed courtyard style area with outside furniture provided. Full details of the facilities and services offered in the home may be obtained by contacting the manager of the home. The current rate of charges are £373.00 to £696.00 per week, this is dependent upon the level and type of care required. There are additional charges made for matters such as hairdressing, personal toiletries or the purchase of newspapers. Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The assessment of this service took place over several months. A random visit was undertaken by Diane Jinks and Penny Wilkinson in October 2007 to check compliance with a Statutory Requirement Notice that had been issued in September 2007. The pharmacy inspector, Angela Branch accompanied us on the random visit. Diane Jinks, Jenny Donnelly and Angela Branch undertook this key inspection visit to Riverside Court. The service was assessed against the national minimum standards for Care Home for Older People. The methods used to assess the service included: • A short observational assessment, which involved observing the interactions of some staff and people using this service. • Discussions with people living at the home and staff working at the home, including the manager. • Surveys were sent to a selection of people living at the home, their relatives and health and social care professionals. The information gathered from these methods helped to validate the findings of this inspection visit. What the service does well: What has improved since the last inspection? The care plans of people living at the home have improved greatly and generally reflect their care and support needs accurately. There are some gaps and these have been discussed with the manager. Much work has been done to improve the quality of medicines handling however further improvements are still needed to protect residents from medication errors. Records relating to medication are well kept and clearly show the treatment received by residents, and all medicines could be accounted for. There is minimal use of “when required” sedating medicines and this benefits residents by reducing risks from unnecessary medication. Improvements have been made to the general environment at the home. Many areas have been redecorated with carpets and curtains being replaced too. Housekeeping staff are being provided with training and take pride in their Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 6 work. This helps to ensure that the home provides a pleasant and comfortable environment for people to live in. Comments were received about the environment with one person stating ‘that awful smell has diminished noticeably’. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 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 Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 only. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service have had their care needs assessments reviewed and updated. This will help to ensure that people have their needs and expectations met in the most appropriate way. EVIDENCE: There have been no new admissions since the last inspection visit to Riverside Court. A sample of three care files belonging to existing residents was looked at during this visit to the home. It is evident that care needs assessments have been reviewed and updated to reflect the current needs and requirements of the people using this service. The manager indicated that the general assessment process has been reviewed to help ensure that the home only admits people who’s needs they are confident that they will be able to meet properly. This means that people living at the home should receive appropriate care and support in order to meet their health and social care needs. Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People using this service generally have a plan of how their health and social care needs will be met. There are some gaps in these plans, which could compromise the health, safety and well being of people using this service. EVIDENCE: The care plans of six people who live at the home were looked at. In general the care plans are much better than seen previously and clearly record the care needs and support that each person requires. The care plans show involvement with other professionals such as doctors, dentists, occupational therapists, community nurses and speech and language therapists. Care plans are generally reviewed on a monthly basis to help ensure that they are up to date and continue to reflect the needs of the people using this service. Care plans include an element of risk assessment; nutritional assessment and wound care assessments. Although these assessments are generally up to date there are some gaps that require attention. For example, where treatments have changed they are not always recorded in the care plan. One person has recently had bed rails fitted to their bed. There is no evidence to confirm that a Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 10 full assessment has been undertaken or whether alternative methods for maintaining safety have been considered. The same person has also suffered significant weight loss and although the care plan states that weekly weight should be monitored the records indicate that this is not carried out. Three people have recently been seen by a dentist because of poorly fitting dentures or sore gums. The records indicate that no further treatment will be undertaken and this results in a poor outcome for these people and there are no records to show that the home will continue to take up the matters on their behalf. This was discussed with the manager during the visit to this service. The service looks after and administers medication on behalf of most of the people living there. Residents are also supported to look after and take their own medicines if they wish and are able to. This allows them to remain as independent as possible. Records for receipt, administration and disposal of medicines are mostly complete with only occasional omissions. Records for a sample of medicines were checked. They show that medicines occasionally run out and people do not have the treatment they need. Ordering systems must be reviewed to prevent this occurring. In most cases medicines are administered in the prescribed dose. Occasionally medicines are not given as the doctor intended, especially when medication changes are made. This leads to residents receiving incorrect treatment that could be ineffective or harmful. All medicines must be administered as prescribed by the doctor to provide safe and effective treatment. Systems for communicating medication changes and records relating to them must be improved to prevent administration errors. Care plans are in place for the use of “when required” medicines such as sedatives so that people receive them appropriately. This prevents unnecessary treatment that could result in side effects such as over-sedation and increased risk of falls and injury. “When required” sedatives are used only occasionally and records show that they are given in accordance with the care plan. However, care plans for the use of rectal diazepam for epileptic seizures should be reviewed to include more detail. The service has a system of weekly quality checks to help make sure that medicines are handled safely and to identify and correct any problems without delay. These need to be more thorough as some errors found during the inspection were missed during a recent quality check. Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements have been made to the way in which people are supported to make decisions and choices in their daily life. There are still some gaps that need attention to ensure that people living at the home are always treated with respect and dignity. EVIDENCE: The home was busy preparing for Christmas. It had been nicely decorated throughout and some of the people living at the home had decorated their own bedrooms. There is a list of activities and entertainments posted in various places throughout the home, although this may not always be in an appropriate format for people to understand. Local schools are going to visit the home to sing carols. One resident in particular is looking forward to this. Some people living at the home have been shopping in Carlisle and a trip to see the Christmas lights has been organised. The home employs activities co-ordinators and there is an activities room, which is equipped with games, craft materials, videos and music cassettes. There were no organised activities taking place on the day of our visit to the home. Records are kept of activities and include softball, bingo, music, massage and sing-a-longs. Some work has started to be done with the Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 12 community psychiatric nurses in producing ‘life stories’ for each resident. This will help the home plan for suitable activities and stimulation that meet the needs of people living at the home. Some of the people who completed surveys say that the staff who organise activities ‘do a very good job’. There were relatives and friends visiting the home at the time of our visit. They were made welcome by the staff and offered refreshments. People are able to see their visitors in the privacy of their own rooms or in one of the communal areas as they choose. The manager has started to hold residents/relatives meetings each month, although these are not always as well attended as they might be. Some areas of the home have been redecorated. People living at the home have been encouraged to help choose the colours and designs of the new carpets and curtains. Some improvements to the menus were seen. People have a choice of two options at each mealtime and snacks and drinks are provided throughout the day. The manager has produced a leaflet/menu of all the snacks that are available to people living at the home throughout the day. The leaflet is on display in the main reception and in the dining rooms. The leaflet is currently available in one written format and may not be suited to meet the needs of all the people living at the home. Additional meals have been added to the vegetarian menu, but this would benefit from further work to ensure that people choosing the vegetarian option, receive a nutritionally balanced diet. A short observational assessment was undertaken by one of the inspectors during this visit. It was carried out over the lunchtime period in one of the dining rooms upstairs. One person was fed extremely quickly by one member of staff. This was not in accordance with the instructions recorded in the care plan. Although there was some interaction between staff and residents, this was not always positive. For example a staff member did not engage in any conversation with the person she was helping to feed. She did not explain what the meal was and at the end of the meal the person was wheeled away, again without any explanation. Other staff were observed supporting people with their activities in a kind, caring and patient manner. Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements have been made to help ensure that people using this service are protected from abuse, harm and injury. EVIDENCE: There is a comments and complaints procedure in place at the home. This is included in the home’s Statement of Purpose and is displayed on notice boards at the home. Some of the people participating in this inspection indicate that they are aware of the process and know who to raise their concerns with. Residents and relatives meetings are held and these help to provide a forum for people to raise any concerns that they may have about the home or the service it provides. The home continues to receive extra support from the Adult Social Care Team, Primary Care Trust and the Mental Health Team. This group are helping to improve the service for people with dementia and some staff training has been arranged. The manager is also in the process of undertaking a course in dementia awareness to help raise his understanding of this illness. The majority of staff employed at the home have undertaken training in safeguarding adults and are aware of the whistle blowing procedures in place at the home. This helps to ensure that people living at the home are protected from abuse and harm. The manager is aware of the safeguarding procedures and responds appropriately to any suspicions or allegations of bad practice, notifying both adult social care and the Commission for Social Care Inspection. Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 14 Improvements have generally been made to the risk assessment process, although there are some gaps that need attention to ensure that people are fully protected and safeguarded. The pharmacist inspector noted that “when required” sedatives are used only occasionally and records show that they are given in accordance with the care plan. This prevents unnecessary treatment that could result in side effects such as over-sedation and increased risk of falls and injury. Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 15 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): Standards 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is generally clean and safe. This means that people living at Riverside Court are provided with a pleasant and comfortable environment. EVIDENCE: The home was clean and tidy on the day of this visit and decorated ready for Christmas. Many areas have been redecorated and carpets and curtains have been replaced. Communal bathrooms, shower rooms and toilets are generally clean and well maintained. Shower curtains have been fitted to the shower rooms making the rooms warmer and more private. Mirrors, flowers and pictures have been placed in the bathrooms to help improve the environment and give them a more ‘homely’ outlook. There is one bathroom on the ground floor that is not particularly clean, including the seat of the bath hoist/chair and this could raise the risk of cross infection. There are numerous toilets throughout the home and these were also clean and tidy. However, many of the toilet seats are very Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 16 loose. This is a long standing problem at the home that needs urgent attention to reduce any risks to the health and safety of people living there. The communal areas are all fitted with aids and adaptations to help people access them independently. All the bedrooms at the home are for single occupancy and have en-suite facilities. People living at the home are able to bring in their own personal items such as pictures, ornaments, televisions and small items of furniture. This helps to make their rooms feel more homely and comfortable. There have been issues at the home regarding the standard of cleanliness. One of the housekeepers was spoken to during this visit. She explained that the home has developed cleaning schedules and people are given responsibility for certain areas of the home. The manager carries out frequent audits of the cleaning schedules. The housekeeper also said that the domestic staff employed at the home are to receive further training, including National Vocational Qualifications (NVQ). She was very enthusiastic about this and felt that it would add to the improvements already made at the home. Staff training records show that staff have received training in the control of infection and this has contributed to the environmental improvements at the home. Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 17 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): Standards 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The skills, experience and numbers of staff on duty may not always meet the needs and requirements of people using this service. This could sometimes compromise their health, safety and well being. EVIDENCE: On the day of our visit to the home, there were eight members of staff on duty and working over the two floors. Members of staff include qualified nurses and care assistants. People taking part in this inspection indicate that there are usually enough staff on duty. However, most of the people living at the home require assistance from staff with dressing, bathing and going to the toilet. A significant number of residents also need assistance with eating their meals or require two or more staff to help with their care needs and some concerns have been raised. One relative was concerned about the layout of the home and that at times few staff were spread out across a large unit, often leaving high dependency residents on their own. Another relative also raised concerns about the staffing levels and the fact that in some areas of the home residents are ‘very spread out’. If there are insufficient numbers of staff on duty, people may not receive the support they need and are placed at risk from harm. Samples of staff recruitment and staff training records were looked at during this visit. The recruitment records show that prospective staff complete application forms and attend for interviews. References are taken up and Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 18 checks with the Criminal Records Bureau (CRB), Protection of Vulnerable Adults (POVA) and the Nursing and Midwifery Council (NMC) are made. This helps to make sure that only suitable people are appointed to work at the home. Staff training has been an area of concern. Staff were observed working with residents during this visit and many examples of good practice were seen. However, poor practices were also apparent but these could be remedied with a little training and support. Evidence was seen during this visit to confirm that the manager at the home is taking staff training very seriously. A staff training and development plan has been produced and time has been set aside each week for staff training to take place. The majority of staff have undertaken recent training in safeguarding adults and infection control. Trained nurses have received refresher training in the safe administration of medication. The training plan includes subjects such as food hygiene, health and safety, care planning, dementia care and fire safety. Manual handling is also included in the training plan. This is a subject that needs to be covered without any further delay to ensure that all staff are up to date with handling techniques. This will help to reduce any risk of harm or injury to staff or people who use this service. Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 19 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): Standards 31, 33, 36 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager generally tries to ensure that the home is run in the best interests of the people that live there. EVIDENCE: The home was issued with a Statutory Requirement Notice in September 2007. This means that the service had not been complying with legislation and had not been meeting the National Minimum Standards for Care Homes for some time. Four Seasons Health Care (the owners of the home) provided an action plan describing how improvements would be made to the service, within the specified timescale. We carried out a random visit of the service in October 2007 to check that the home was complying with the law. During that visit we were very encouraged with the improvements that had been made and the support that had been provided to the manager to help him with this task. Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 20 The manager has ensured that the improvements have been sustained over the last few months. We are optimistic that the plans and arrangements in place at the home will help to ensure that the service continues to improve. As well as developing a staff training plan, the manager is also updating his skills and knowledge. He is currently undertaking a diploma in dementia care and also plans to undertake the registered managers award. A new deputy manager and an administrator have been appointed at the home and this will help and support the manager in his role. As part of the quality assurance programme at the home, internal audits are undertaken frequently. This means that records are checked and staff and residents are spoken to for their views and opinions. A residents/relatives meeting is organised on a regular basis and the manager has commenced meetings with the local adult social care team, Primary Care Trust and the Mental Health Trust. These links should also help bring about and maintain improvements to the service. Staff records show that most staff at the home receive supervision and have their practice monitored. This does not yet take place as frequently as it should do. The manager has delegated some of the responsibility of this task to other staff to help make sure that staff are supervised properly. Staff supervision requires special skills and consideration should be given to providing these staff with training in supervisory techniques. The manager has started to develop safe working practices and training courses are organised for staff. This will help to update their knowledge and skills and promote health and safety within the home. The home has produced a new environmental risk assessment file, which covers various subjects including the use of the minibus and safety in the kitchen. General health and safety risk assessments are undertaken and recorded in individual care files. There are some areas that require further work to ensure that these documents are as detailed as possible, for example the use of bed rails. This will help ensure that residents and staff are protected from injury. Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 21 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 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 2 X 2 Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 22 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 15 Requirement People living at the home must have an up to date plan of their care. Where changes to their treatment or needs have been identified, this must be recorded to ensure they receive the right type of support and care. Timescale for action 31/01/08 2. OP9 13 The registered person must 31/12/07 ensure that medicines are given as the doctor intended. (Previous timescale of 01/11/07 not met). Medicines must not be allowed to 31/12/07 run out Where people require assistance with eating and drinking, this must be provided in a sensitive, respectful and dignified manner. 31/12/07 3. 4. OP9 OP15 13 12 5. OP19 13 Bathrooms, showers and toilet 31/01/08 facilities must be kept free of hazards at all times. In particular the loose fitting toilet seats. This will help to minimize the risks that they present to people living in the home. Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 23 6. OP38 13 Suitable arrangements must be made to ensure that people using this service are not placed at risk from harm injury. This includes ensuring risk assessments are up to date and accurate and that staff are provided with proper manual handling training. 31/01/08 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 OP12 Good Practice Recommendations It is recommended that the arrangements for leisure, social and recreational activities continue to be monitored, reviewed and updated in consultation with people living at the home, to suit their needs, preferences and capacities. Consideration should be given to the numbers of suitably qualified and competent staff on duty. This should take into account the needs and numbers of people living at the home as well as the physical layout of the home. This will help to ensure the health, safety and welfare of people living at the home. The progress of the staff training and development plan should be monitored frequently to ensure staff are developing and updating their skills and knowledge. Training in supervisory skills should be considered for staff with the responsibility of supervising and monitoring staff care practices in the home. 2. OP27 3. OP30 4. OP36 Riverside Court Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Nursing Home DS0000010105.V351648.R01.S.doc Version 5.2 Page 25 - 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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