This inspection was carried out on 31st March 2010.
CQC found this care home to be providing an Poor service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: Riverside Court Nursing Home 31 Irish Street Salmoor Way Maryport Cumbria CA15 8AZ zero star poor service 17/12/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Diane Jinks Date: 3 1 0 3 2 0 1 0 Information about the care home
Name of care home: Address: Riverside Court Nursing Home 31 Irish Street Salmoor Way Maryport Cumbria CA15 8AZ 01900815323 01900815033 riverside.court@fshc.co.uk www.fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Manager Post Vacant Type of registration: Number of places registered: Conditions of registration: Category(ies) : Tamaris Healthcare (England) Ltd care home 60 Number of places (if applicable): Under 65 Over 65 0 60 dementia old age, not falling within any other category Conditions of registration: 30 0 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 Brief description of the care home 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
Care Homes for Older People Page 2 of 12 Brief description of the care home 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 charges, facilities and services offered in the home may be obtained by contacting the manager of the home. There are additional charges made for matters such as hairdressing, personal toiletries or the purchase of newspapers. Care Homes for Older People Page 3 of 12 What we found:
This random inspection was undertaken to follow up Statutory Requirement Notices issued to the organisation in March 2010. The service had failed to comply with requirements relating to the care needs assessments and care planning arrangements of people living at Riverside Court, which had been made at previous inspections. On the day of our visit there were 44 residents at Riverside Court. We looked at a sample of five residents care needs assessments and care plan records. We found that generally these have been reviewed and updated. More relevant information has been recorded and care plans have been updated or replaced where necessary. Audits have been carried out by the manager regarding the content and quality of assessments and care plans although this has not always been done thoroughly. The provider told us that random reviews of the content and quality of these assessments will continue and improve further. The acting manager told us that by reviewing peoples care needs assessments and care plans, other issues have been identified. For example some people needed to have thorough nutritional assessments and the findings from these have now been passed to their doctor for further action. We found that some people have already been seen by the doctor about their nutritional needs. The new acting manager told us that she has met with relatives to try to get care plans up to date and sorted out. She has also spoken to residents about their care plans and their needs. We found that the care plans we looked at have been reviewed and updated accordingly. Where people have specialist needs, we found that nursing observation charts are now kept and maintained in each individual bedroom. For example bed rail visual checks and records, resident positioning charts, food and fluid intake records. These records show that people are having their skin and pressure areas monitored as well as their dietary intake. We found that the home has started to provide staff with training to help ensure they understand and practice the ethos of person centred care. The manager told us that she intends to continue working with staff and supporting them in developing and improving person centred care provision. We spoke to some of the staff that work at the home. They confirmed that they had started to receive training to help them with care needs assessments and the development of meaningful care plans. One person said; a lot of work has been done on getting paperwork up to date and correct despite staff morale being low at the moment. There have been a lot of managers over the last year, resulting in different management styles and inconsistencies. Another person said; I have noticed the improvements to the environment at the home and also improvements to the care records. I have attended the care plan training and although they had been long days, they were worthwhile. I feel more confident and know what should be written and recorded in care plans. This person also spoke of the new manager and described her as supportive and helpful.
Care Homes for Older People Page 4 of 12 We had a look around the home during this random visit to check that the provider has started to action the points raised with them regarding the standard of the environment at Riverside Court. We found that the long standing problem with the windows has been address. All the windows were in a good state of repair. Appropriate waste bins have been placed in bathrooms, many of the bath and shower rooms have been renovated or are in the process of being updated and the sluice area was cleaner and tidier. These measures will help to reduce any risks of cross infection. We did note that some of the grab rails in some of the assisted toilets were loose and needed minor repairs. Some of the light cords and call bells were out of reach of the residents occupying those bedrooms affected. The acting manager spoke with the maintenance person during our visit and instructed him to attend to these matters straight away. We discussed with the acting manager, the future management arrangements for Riverside Court. The home has not had a registered manager for the past year. This now needs to be addressed quickly to help ensure that the home is managed in the best interests of the people that live there and that improvements to the service continue to be implemented with consistency. The current acting manager told us that she intends to apply for registration with the Care Quality Commission and we discussed the new registration process with her. What the care home does well: What they could do better:
We found some issues with care plans relating to medication and the acting manager needs to review and check the instructions recorded in them. For example one care plan indicates that one medicine is given when required but the review of the care plan states that a daily dose is administered. This conflicting information could mean that people do not always get their medicines as the doctor intended. Another persons care plan records that their medication is given with food covertly after discussion with daughter and GP. Further work needs to be carried out, including consultations with health and social care professionals to help establish this as appropriate. Medications may not be suitable for administration by this method and we discussed this with the manager during our visit. Some care records do not clearly indicate that independence is always recognised and
Care Homes for Older People Page 5 of 12 promoted. One care plan identifies that a fairly independent person needs some assistance with personal care needs but the records do not identify the things this person could manage for themselves. We also saw that a bed rail assessment and consent form had been signed and agreed by a relative despite the person clearly having capacity for their own decisions. We saw a document relating to end of life arrangements on one care file. The document has not been properly completed and there is no evidence to show that the individual concerned has been involved in this decision. We discussed this with the acting manager and suggested that she obtained legal advice on this matter to help ensure it is compliant with legislation such as the Mental Capacity Act and Deprivation of Liberties guidance. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 12 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 3 14 People must not move into 01/02/2010 the home without a full and detailed assessment of their health and social care needs. Regard must be given to the findings of the assessment to help ensure that the home will be suitable and able to meet the needs of the potential service user. 2 9 13(2) There must be a system for checking for unexpected changes in medication to reduce the risk of errors. 01/02/2010 3 9 13(2) Medicines must not be allowed to run out. 01/02/2010 4 9 13(2) Staff must ensure that 01/02/2010 medicines are administered in the correct dosage so that people receive safe and effective treatment. This was to have been met by 01/02/09. 5 9 15(1) Care plans must be more thorough to provide staff 01/02/2010 Care Homes for Older People Page 7 of 12 Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action with clear guidance on managing residents with specific care needs for the administration of complex or when required medication so that they are managed safely and effectively. 6 9 13(2) All records for medication must be accurate to prevent mistakes that could result in inappropriate administration of medication. 01/02/2010 7 15 16 People must receive a varied, 28/02/2010 wholesome, appealing and nutritious diet. Individual requirements must be taken into consideration. Where necessary clear and detailed records must be maintained and healthcare professionals contacted for advice and assistance. 8 30 18 All staff employed at the 31/03/2010 home must receive appropriate training in accordance with the aims and objectives of the home and to meet the changing needs of people living at the home. This was to have been met by 31/03/09. 9 31 9 The service must be run and 31/03/2010
Page 8 of 12 Care Homes for Older People Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action managed by a qualified, competent and experienced person who is registered with the CQC. 10 36 18 Staff employed at the home 01/02/2010 must be supervised and have their care practices monitored on a regular basis. This was to have been met by 31/03/09. 11 37 17 Records must be maintained 01/02/2010 in an accurate and up to date manner. Records and confidential information must be stored securely and in line with current legislation. 12 38 13 The health and safety of 01/02/2010 people using this service must be protected and promoted. Unnecessary risks to the health and safety of people using this service must be identified and so far as possible, eliminated. Care Homes for Older People Page 9 of 12 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 9 13 There must be appropriate and safe arrangements in place at the home to ensure medication is administered safely and appropriately. People using this service must receive their medication safely and as the doctor intended. 30/04/2010 2 11 12 The wishes and feelings of 30/04/2010 people using this service must be ascertained and taken into account as part of the health and care provision. People using this service must be enabled, with the help of advocates if necessary, to make decisions about the care they receive in respect of their health and welfare. Care Homes for Older People Page 10 of 12 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 31 The provider should ensure that a suitable manager is appointed for the service and is registered with Care Quality Commission, without delay. Care Homes for Older People Page 11 of 12 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 12 of 12 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
