Inspection on 10/01/06 for Riverside House

This inspection was carried out on 10th January 2006.

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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Riverside House 15/01/09

Riverside House 25/01/07

Riverside House 25/01/05

Riverside House 27/07/04

Riverside House 18/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Riverside House Quay Lane Broadoak Newnham-on-Severn Glos GL14 1JF Lead Inspector Peter Still Unannounced Inspection 10th January 2006 09:45 Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 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 House DS0000016560.V272430.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 Adults 18-65. 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 House DS0000016560.V272430.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Riverside House Address Quay Lane Broadoak Newnham-on-Severn Glos GL14 1JF 01594 516291 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) Stepping Stones Resettlement Unit Limited To be appointed Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th August 2005 Brief Description of the Service: Riverside House is a residential care home for 13 people with learning disabilities who may also present challenges to the service. The property is an old rambling building of character. There are many levels and accommodation is broadly provided over three floors plus a mezzanine area and basement. Each person has single accommodation with a hand wash basin and access to either a bath or shower room. People living at the home have access to two lounges and a dining room, plus a games room in the basement. One person living on the top floor has a separate lounge. Gardens to the rear are well maintained. Riverside House is situated approximately 14 miles from Gloucester in a rural area with views of the River Severn. It is owned by Stepping Stones Resettlement Unit Ltd, which owns five other homes in the area. The home is being managed by a newly appointed manager who has applied to become registered manager for the home. Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over four hours. The acting manager and three other staff were specifically spoken with and there was communication with four of the eleven residents. A tour of the building was conducted and a number of files were reviewed. What the service does well: What has improved since the last inspection? Team spirit had improved further since the last inspection and an example of this was the Christmas period, where residents spent all their time with the home staff. It was understood that staff made every effort to put the residents first, duties were fully covered and the residents were able to enjoy a happy time with staff. Staff morale was described as very good by staff spoken with. Systems for the running of the home had been refined over the last six months and tested; staff said they were working well. The outcome for staff was that confidence had grown, they were more accountable for their work and responsibilities. Staff were also comfortable in expressing ideas for development of practice. A service user questionnaire with feedback was completed in November. Amendments to the Statement of Purpose and Service User Guide had been completed and sent to CSCI for information. Items from the last inspection had been addressed. Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 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. Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 Adjustments to the Statement of Purpose and Service user Guide had been made so that prospective residents can make informed decisions about where to live. EVIDENCE: All points raised at the last inspection concerning the Service User Guide and the statement of terms and conditions had been responded to. Makaton was being used and a version of the Service User Guide had been provided on tape for those who need it. Staff training for Makaton was also available. Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Care plans provide good detail of residents needs. Residents were supported in making decisions along with the consideration of risks to promote independence and choice. File holders were in poor condition and must be replaced. EVIDENCE: Residents were aware of, and supported by, their key worker in understanding and reviewing their care plans and one resident was able to talk about their plan. Two care plans reviewed were signed by the resident. The manager plans to introduce a new system called the Behaviour Support Plan to provide greater clarity of key needs and issues with the agreed way in which staff should work with residents. The new system is complex and will take some 12 months to fully introduce and work will start on this by summer time. Lever arch care plan files were in poor condition and many were not working presenting a risk that staff would not read key information due to the difficulty of access. They need to be replaced. Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 10 Residents were helped to make decisions about their lives with risks assessed to promote choice and independence. One resident talked about the risks in their life and the way staff support is given. Evidence included: decision making concerning holidays, which vary between residents, cycling, jobs, shopping and trips out. A central aim of the home is to ensure residents are able to make their own choices. Documentation and recording had improved, supporting better risk assessment and care planning. The manager keeps systems simple for staff to use, which they said they were happy with. Inappropriate terminology used concerning residents had been addressed. A risk assessment for a resident who cuts grass at the home had been completed and steel cap boots used when needed. Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 16, 17 Residents enjoy a busy life with a range of activities available to them. Privacy was respected and provision of choice is key to the ethos of the home. A healthy diet was offered. EVIDENCE: Residents enjoy visits to shops and the local pub, where they are known by name. On occasions all residents are away from the home with staff or engaged in activities. During warm weather, residents prefer to spend a lot of time outside in the grounds of the home, where they often have their meals. Each evening a member of staff takes one of the residents out for one to one time. Staff took care to knock before entering bedrooms and bathrooms, ensuring privacy. Staff discuss with residents about their food and preferences and residents said they enjoy the food. A very tasty breakfast was being prepared at the beginning of the inspection and meat was locally sourced from a well regarded butcher. A record was being maintained to record the dates the fresh eggs were supplied from the farm. Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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 New health recording systems will help to protect residents. The medication system had been improved and further steps to strengthen the dispensing of medication was about to be introduced to ensure policy would be complied with. EVIDENCE: A new Health Action Plan system, was being introduced, providing comprehensive and easy to reference individual documentation. A photo of the resident was to be added to the front of the files. Once fully introduced an evaluation would ensure further development and adjustment as needed. The last inspection noted a number of faults with the medication system, which the manager had resolved. Creams and sprays were no longer being used and if needed would be provided by the GP under prescription. Blister packs were being used for resident’s medication and the Stepping Stones nurse had checked the system the previous week. The inspector started the inspection towards the end of breakfast, when medication had been completed for residents. It was noted that the home was very busy and loud during this time and the four members of staff were working hard to meet the high number of needs at this time of day. A senior member of staff noticed a tablet, which had fallen onto the floor. The resident Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 13 concerned takes a number of tablets and prefers to take them all together. Staff have a difficult balance of helping residents who may challenge the service and who may refuse medication; keeping the process in the control of the resident as much as possible. The senior member of staff took proper steps and said the problem had already been identified as a rare occurrence but one that can happen. He said he was about to pilot the introduction of a slight change to the system to ensure staff can deal with medication in a quieter place and with one to one staff supervision. A requirement will be made to review the system and to support a new approach to ensure residents are protected. Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Resident meetings need to be held to ensure views are sought. Residents are protected by staff that have been trained concerning the protection of vulnerable adults. EVIDENCE: Whilst staff talk to and listen to residents views constantly, residents meetings need to take place and the manager plans to establish these on a monthly basis. Staff received training concerning adult protection and abuse on 28/09/06 and were aware of the steps to take if there were a concern, or abuse was seen. Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 The environment was homely and ongoing maintenance provided to keep the home in good condition. One window restrictor was needed and a check should be made of all windows. The home was clean and tidy. EVIDENCE: Work was ongoing to ensure the home was well maintained. This is particularly necessary, where residents may be a challenge to the service. The electrical appliances were being tested during the inspection for the annual PAT test and the engineer was carefully undertaking this crucial task and being mindful of the needs of residents re his plan of work. Bedroom 12 did not have a window restrictor and the provider should consider the recent national guidance issued by the health and safety executive, called “Falls from windows in health and social care” before the work is completed. Guidance from the fire prevention service must also be sought. A senior member of staff was seeking action concerning the window on the day of inspection. The bedroom was not in use at the time. A review of all windows must take place, with adherence to the national guidance. Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 16 A toilet noted as having a pungent smell at the last inspection was being refurbished on the day of inspection and the WC had been removed. Lounge carpets were being regularly cleaned. A member of staff works five days a week to keep the home clean. The layout of the home and needs of resident’s makes this a very important role. Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34, 35 An effective staff team, recruited following the standard and home policy support resident’s care. The lack of staff qualified at the home was a concern and being addressed. EVIDENCE: The manager has supported the development of a staff team with a strong sense of commitment and team spirit and new staff had been inducted into the three staff teams. Within the previous twelve months, the majority of support worker staff had changed at the home, however at this inspection, staffing had stabilised and there were no vacancies. Two confident and experienced senior members of staff were spoken with, they provide good leadership to their teams and supporting the manager well in the development of the home. It was said that the home had moved through a difficult period and that staff were very happy with the style of the current manager. Staff were encouraged to make their views known and staff were valued for their contribution to the running of the home. Issues raised at the last inspection about recruitment practice had been attended to and the home policy was being followed. Since a number of staff had left the home, further NVQ training was needed. The manager had taken steps to addressed this and the current situation is that one member of staff holds NVQ level 2; three staff were undertaking Level 3 and four staff were awaiting a place on the Level 3 course. Staff should be Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 18 commended for seeking the higher level 3 award. A requirement will be made for the manager to support the staff as they work through their training. The staff training matrix for the home had been completed and was reviewed at the inspection, showing the variety of training staff had been undertaking including the Learning Disability Award Framework. Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Residents enjoy a happy atmosphere at the home and a consistent approach promotes a feeling of security. Meetings with residents must be established to involve residents in the running of the home. Staff were proactive in promoting health, safety and welfare to protect residents. EVIDENCE: There was a strong sense from staff that the home was being well run and senior staff were clearly supportive of the manager who works mainly in a supernumerary capacity, covering all shift periods during the day and weekends to provided leadership and ensure a good understanding of the way the home is running. Wednesday is used as the key handover day, when each of the three shifts spend time together to ensure they are fully up to date with residents needs. Each day staff also hold a comprehensive handover session. A requirement will be made to establish meetings with residents so that their views can be taken into account in underpinning the self-monitoring, review Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 20 and development of the home. The manager said he has this work planned but it is yet to start. Staff demonstrated the importance of health and safety and of taking immediate steps when necessary. During the inspection the issue about a tablet and a window restrictor was evidence of staff taking action, as well as the PAT testing being undertaken. A senior member of staff gave a good description of how he assesses the home and ensures matters were attended to and another member of staff was seen to be completing a request for remedial works. Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X X X X Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X 3 3 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Riverside House Score X 2 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X 3 X DS0000016560.V272430.R01.S.doc Version 5.0 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA24 Regulation 13 (4) Requirement Timescale for action 31/03/06 2 YA39 12 (3) 3 4 YA20 YA41 13 (2) 17 Review all windows to ensure restrictors are in place to meet Health and Safety and Fire Prevention guidance. Establish regular meetings with 31/03/06 residents to gain views, feedback and to involve residents in the running of the home. Support a review and additional 28/02/06 step to tighten the dispensing of medication Replace damaged care files 31/03/06 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 YA19 YA32 Good Practice Recommendations The provider should continue to support the work of the manager to introduce the new “Health Action Plan”. The manager should continue to support staff as they work through their NVQ training. Riverside House DS0000016560.V272430.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 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 House DS0000016560.V272430.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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