Inspection on 22/02/06 for Riverside Grange

This inspection was carried out on 22nd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 Grange 16/01/09

Riverside Grange 28/01/08

Riverside Grange 23/01/07

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

CARE HOMES FOR OLDER PEOPLE Orchard Garth 2052a Hessle High Road Kingston upon Hull East Yorkshire HU13 9NN Lead Inspector George Skinn Unannounced Inspection 22nd February 2006 09:30 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 Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 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. Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Orchard Garth Address 2052a Hessle High Road Kingston upon Hull East Yorkshire HU13 9NN 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) 01482 581000 Humberside Independent Care Association Care Home 33 Category(ies) of Dementia - over 65 years of age (33), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (33) Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. To admit two service users under pensionable age. Date of last inspection Brief Description of the Service: Orchard Garth is a purpose built home, which has been operating since March 1991 it has recently been purchased by the Humberside Independent Care Association (HICA) who are a not for profit organisation. The building is on Hessle High Road, near to a Sainsbury store and about one mile from the centre of Hessle, which has a good variety of shops, pubs, banks and other facilities. The home is on a bus route and buses run regularly between Hessle and Hull. The home provides a service for elderly people who may have a mental disorder or suffer from dementia. The home has 33 single rooms, on two floors, all with en-suite toilet. There are four bathrooms, one shower room, and two lounge/dining rooms, as well as a large conservatory. Ancillary services include staff room, laundry and kitchen. There is a small garden area by the car park to the front of the house, but service users do not go there because it is not secure. There is a secure garden for service users which is located to the side of the home and can be accessed via the conservatory. Double-locking doors can be found throughout the home to ensure safety of service users who are mobile and wish to walk about the home. Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection of the home since the new owners HICA have taken over. It was an unannounced inspection undertaken over 7 hours it included speaking to residents, looking at records and inspecting the building. All the key standards were looked at. It was difficult to ascertain the views of the residents due to their varying degrees of dementia however those relatives spoken with were very positive. What the service does well: What has improved since the last inspection? The home is being fully refurbished new records are being introduced and new staff have been recruited, it is intended that all aspects of the home will be improved to meet the very high standards which HICA as a company provide. Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 Page 6 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. Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 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 Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 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): Residents’ have their needs assessed prior to moving into the home. EVIDENCE: The home is currently updating all the information which was inherited from the previous owners. The residents’ case files are being updated and all information is being transferred to HICA documentation. The records which are kept on each resident will be comprehensive and detailed to enable the staff to provide the care the residents require to meet their needs. Staff will be well instructed on how to care for the residents and meet their needs in an appropriate manner. All those files inspected contained copies of assessments undertaken by the relevant professional. Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 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 & 10 The residents personal social and care needs are set out and their health needs are full met. The homes procedures and practises regarding medication protect the residents. Residents are treated with respect. EVIDENCE: HICA are transferring the current information on each resident to new documentation. This documentation is very detailed and outlines the way in which each resident should be cared for and their preferences; it also details their health needs and how these should met, records indicate that the GP is called and visits are undertaken by the District Nursing services. There is evidence of consultation with Community Psychiatric Nurses when required. There is a detailed medication policy in the home about the handling of medication. Records of medication received into the home are well maintained along with their administration and disposal. The home does not routinely Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 Page 10 facilitate self-medication. Those residents whom wish to self medicate would be enabled in this process, subject to an assessment and agreement. Appropriate storage facilities for controlled medication are available. Some medication is stored in a fridge; the temperature of this is monitored and recorded on a daily basis. Senior staff have been trained and assessed as competent to administer medication in the home and sample signatures are retained. The health of residents on medication is monitored and recorded in case files and regular medication reviews take place with the GP. The organisation has developed a medication-training package, which has extend to a formal assessment process based on competency and understanding, there is also a commitment to training all staff to an accredited level. The maintenance of residents’ privacy and dignity forms part of the staff block induction programme. Observation made indicated that privacy and dignity is respected whilst personal tasks are being undertaken, assistance is always available but where possible independence is enabled. Medical examinations/ treatment is conducted in the privacy of the residents’ own room. Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 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, 13, 14 & 15 The resident expectations are satisfied and their cultural and religious needs are met, and contact with families are maintained. Residents are as much as possible helped to exercise choice in their daily lives. Residents are provided with a balanced diet. EVIDENCE: Staff provide a variety of choice and flexibility in the daily lives of the residents, with care being given to ensure that it reflects the wishes of the resident. Care plans indicated how even small preferences were to be accommodated Leisure and social activities are arranged both in house and within the local community. Notices of forthcoming social events are displayed around the home. Residents interests are recorded in their individual care plans. Through observation, reading documentation and discussion with staff and relatives it was evident that residents choose when to get up, go to bed, spend time in company, time alone etc. Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 Page 12 Whilst mealtimes are set residents are able to make choices about where they wish to eat and there is some flexibility around the timing and what they would like to eat. Residents are able to receive visitors at all reasonable times. The statement of purpose states that residents are able to choose whom they see and don’t see. No restrictions are placed on visiting. Relatives said they were made to feel welcome by staff. Relatives were of the opinion that sufficient and varied social activities were organised; the home employ an activities organiser. Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 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, 18 Relatives knew whom to complaint to and had confidence that their complaints would be taken seriously. The residents are protected from abuse. EVIDENCE: A complaints procedure is available which encourages residents and relatives to express their dissatisfaction without fear of repercussion. This procedure includes contact details for CSCI. Complaints are seen as an opportunity to improve the service as a whole or more specifically for an individual. Relatives said they felt the management style of the home encouraged them to speak out and they were satisfied that they would be listened to and issues acted on, they would not hesitate in bringing such matters to the staffs attention. Residents are protected from abuse with robust procedures in place for responding to any suspicion. All staff receive formal training on abuse and the protection of vulnerable adults. The home does have a detailed system for the management of residents’ finances, which protects residents from financial abuse. The homes policies and procedures preclude staff from involvement in the making of wills or receiving gifts. Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 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 & 26 The residents live in an environment which is well maintained and clean. EVIDENCE: The home is currently undergoing a full refurbishment and plans are in place to address any shortcomings in the environment. Those relatives spoken with during the inspection commented on the way the building is now looking and were very pleased with the progress that has been made over the last few months. The home has the HICA policies and procedures to follow regarding cross infection and hygiene, and those staff who are responsible for this were fully conversant with them. Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 Page 15 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): The home has enough well trained staff on duty to meet the needs of the residents. The residents are protected by the homes recruitment and selection process. EVIDENCE: At the time of the inspection there were enough staff on duty to meet the needs of the residents. Currently the home is not running at full occupancy but the manager is aware that because the home is new registration it must meet the staffing forum guidelines regarding staffing levels, this will be addressed as the home occupancy increases. There has been a large turn over of staff since HICA purchased the home this is not an unusual occurrence following major changes. All existing staff recruitment files have been updated and the relevant documents obtained and the files have been brought up to the HICA standard; those staff who have been employed by HICA have undergone the process as required by HICA policy and procedure. All staff, existing and newly recruited, have undergone the block HICA induction training. This includes all aspects of basic training to equip carers to Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 Page 16 meet the needs of the residents. The home care for people with dementia and some have advanced stages, therefore the home plan to provide specialist training in this area, again to equip the staff to meet the need of the residents. Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 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): 31, 33, 35 & 38 Residents live in a home which is well managed and run in their best interests. Residents financial interests are safeguarded and their health and welfare is promoted. EVIDENCE: The home is currently managed by a manager who has a long career with HICA; she previously managed a large home in East Hull and has a lot of experience working with people with dementia. She is committed to improving the services offered at the home and has wealth of experience to draw upon. Those relatives spoken with during the inspection were very happy with the management style and felt they could approach the manager if they had any issues, observation indicate that they had a good rapport and effective communication links were maintained. Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 Page 18 The home have implemented the HICA QA system which collates information gathered from various sources, analyses this information and set targets and goals in which to achieve any shortcomings. The results are published and are available for inspection by any interested party. Finances are managed in varying degrees dependant on individual abilities and wishes. This has resulted in a number of families taking care of personal monies whilst others ask the home to keep monies in safekeeping. The home maintains a rigorous system for the safekeeping of monies, with individual details and receipts of any monies spent on their behalf. Hard copies of this account are printed off on a daily basis. This account whilst being rigorous, does fall into the realms of a “communal non-interest account”; from discussions with families, inspection of records and having read information provided to them, it is apparent that any decision to utilise this system have been made by the resident or their representative and is based on individual choice often for convenience. On the basis of these findings this system is acceptable. The organisation ensures that financial audits take place of all monies handled by the home, following these audits a report is produced and any recommendations made are acted upon. The home has a detailed Health and Safety policy. Safe working practices are maintained by the provision of training to staff in the form of moving and handling, basic food hygiene, first aid at work, basic first aid, infection control and fire safety. Systems are in place to ensure that all the homes equipment and building maintenance is up to date. Hazard notifications are circulated to the home manager, action taken and then retained for staff to see. Hot water is regulated to control the risks of Legionella along with the risk of scalding. Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 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 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 Page 20 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Orchard Garth DS0000065164.V278536.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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. 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