Inspection on 15/01/09 for Riverside House

This inspection was carried out on 15th January 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Riverside House 25/01/07

Riverside House 10/01/06

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 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Riverside House Quay Lane Broadoak Newnham-on-Severn Glos GL14 1JF two star good service The quality rating for this care home is: 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tim Cotterell Date: 1 6 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Riverside House Quay Lane Broadoak Newnham-on-Severn Glos GL14 1JF 01594516291 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Stepping Stones Resettlement Unit Limited Name of registered manager (if applicable) Mr Peter Malcolm Williams Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 13 0 care home 13 learning disability Additional conditions: Date of last inspection A bit about the care home 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. Prospective service users and others involved in their care are offered information about the home including copies of the Statement of Purpose and Service Users Guide. Up to date information about fee levels was not obtained during this visit. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home We visited the home on two days, the first day we arrived at 0930 and left at 1645, the second day we arrived at 1000 and left at 1300. During the visits we saw the registered manager and senior support worker and also spoke individually to five support workers who were on duty. The home also completed and submitted an Annual Quality Assurance assessment and this gave comprehensive information about what the home had done and what it proposed in the future. The assessment was helpful in the process of inspection. We looked at the accommodation and the following records, medication, personal allowances, activities, staff rotas and three plans of care. We also spoke to all of the residents, some in a group setting others individually. What the care home does well It was clear that the manager and support staff had a good relationship with residents and were operating as a team providing a consistent and caring service. We saw staff as caring and competent and easily approachable. The staff saw the needs of the residents as paramount and participation by the residents in the day to day activities of the home was actively encouraged. Responsible risk taking was encouraged and protected vulnerable residents to undertake a more individual life style. The environment has been maintained to a good standard and residents saw their bedrooms as their own and with the help of staff have personalized them. The availability of sufficient male and female staff ensure choice and dignity are provided. What has got better from the last inspection The introduction of a key worker system and the decision to revert back to smaller groups for holidays will we feel provide a more personal service based on individual needs. The change in the day care routine appears to be working well and a number of the residents we spoke to appreciated the time given to their individual preferences. It was also evident from our discussions with staff that they also enjoyed this exercise. The complaints procedure is now also available in symbols. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Tim Cotterell 33 Greycoat Street London SW1P 2QF 02079792000 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Based on the comments in the last inspection report the home is completing assessment before each admission. Evidence: There had not been any admissions since the last inspection and at that time we said that comprehensive assessments were completed. We noticed that our address referred to the office in Gloucester whereas the correct address is 33, Cols ton, Cols ton Avenue, Bristol and the relevant records must be amended. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The individual plans of care reflect the needs of the resident. The home encourages independence in a responsible manner and residents are able to exercise choice over how they spend their time. Evidence: The home has two formats which are seen as plans of care. The daily sheets are completed at the end of each shift and clearly indicate what has been happening and the information is collated and added o chart which follows the behavior patterns. We asked the manager to ensure that the plans of care agreed at reviews are related to the daily sheets. It was noted that where guidance from other health acre professions la was needed this was obtained from the local Community Learning Disability Team and recent events had resulted in a clinical meeting being held for one resident to determine how best some behaviors could be managed. Independence is encouraged and a number of the residents are involved in outside activities. Any activity is risk assessed before being undertaken and a number of written risk assessments were seen by us. Residents enjoy a range of activities and were given options wherever possible in respect of how they spent their free time. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents enjoy an appropriate and fulfilling lifestyle in a home which provides stimulation through a variety of activities, residents participate through regaler meetings and there are opportunities for greater Independence through responsible risk taking. Evidence: All residents have a weekly timetable. The majority go to Stepping Stones Care Home which is part of the company which own Riverside, and are involved in the activities. Two residents have a local paper round. Every two weeks each resident has a day care day when they are allocated a member of staff who will be with them exclusively for that day. the resident is able to choose what they wish to day and where they would like to go. On the first day of the inspection a member of staff took a resident to Gloucester this is a one to one facility offered to all residents. We saw evidence of the work with families and it was evident that staff take an active role in helping residents to retain family links. The rights of the residents are safeguarded and we saw one resident deciding not to go to an activity as they wished to stay in the home, this wish was respected by the staff. Residents said that they enjoyed the food and were able to exercise choice over what they ate. We saw one resident enjoying a late breakfast of his choice. Evidence: During the inspection we saw several meals being prepared and served and felt that they were presented in a professional manner. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents well being and safety would be assured if only support staff who are trained deal with other health care professionals. Evidence: The personal support provided in the home is based on the preferences of the individual and this flexible approach ensures that privacy and dignity are provided. We saw the records of the health care received and it was clear that the home is proactive in ensuring all health care needs are met. We looked at the medication records and there were individual records of all medication which had been administered. The home intends to train all staff to administer medicines and the current policy id that only the trained staff are able to administer. We discussed with the man gager how appropriate it was for the cleaner to be advising the local hospital on what medication a resident was taking. We later learned that the cleaner had been a support worker and had been trained to manage medication. We would advise the home to ensue that support staff are competent to manage any matters relating to the administrating or advice to hospitals about what prescribed medication is being taken for individual residents. Ancillary staff may have no responsibility over matters which do not relate to their duties but the home may be responsible for any action the hospital took after receiving the information. It is appreciated that in this case the cleaner may have been competent but the principle of support staff having the responsibility remains. Stocks of PRN are now being checked and all prescribed medication is reviewed every six months. At the time of the inspection there was no self medication. We saw a number of individual protocols for residents who suffer from epilepsy. The Community Learning Disability Team is available to support the home but at the time of the inspection there were not any residents who had been referred to them. Evidence: It would be helpful if the manager had some introductory training in respect of the Mental Capacity Act Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home provides an environment where staff listen to residents and ensure they are protected from abuse Evidence: The home has a complaints procedure. It was appreciated that some resident would have difficulty in complaining however we felt that if there were concerns staff would resolve them informally and promptly. The residents meetings has provided an avenue for residents to raise issues but the manager told us that he was reviewing the purpose and frequency as it was felt that not all residents were enjoying/benefiting from the meetings. All staff have been trained in the identification of abuse and the staff we spoke to were clear about the various forms of abuse. We looked at two records of the personal allowances and in one case there was a small surplus. It is recommended that the balances are checked on a regular basis. The manager was aware of the general advocacy services and the home had used the service for a resident. The home encourages parents and relatives to be involved in the care of the residents and this provides additional support. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home has been maintained to a good standard and provides a comfortable and appropriate environment. Evidence: The home was looked at with a support worker. All of the communal areas were seen and they included a number of lounges which were seen as suitably furnished and in good decorative order. A number of the bedrooms were seen and they had been personalized and this reflected the interest of the individual resident. The bedrooms seen were suitably furnished and in good decorative order. The kitchen and dining room were well organized and the the home was found to be clean and odor free. The recent accident to a resident has highlighted the need for resident to be able to gain access to the home and we were informed that a bell will be installed. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents live in a home where the staff are competent and sensitive to their needs. The flexible service offered ensures that individual needs can be addressed and met Evidence: The registered manager was on duty and he advised us that he intends to complete NVQ level 4 in care he has already obtained the Registered Managers award. During the inspection we spoke to all staff who were on duty and saw the majority individually. We felt that they had a good knowledge in respect of the needs of the residents and were competent and suitably qualified. We were informed that the home intends to ensue that all support staff obtain NVQ 3 in care. They were seen as good listeners when supporting residents and this was evidenced by many interactions during the inspection. We were told by staff that they could access training and were encouraged by their manager to attend all training that was offered. all staff felt they were appropriately trained. The staff rota indicated that there were four members of the support staff on duty during the waking day and one sleeper and one waker at night. The home is fully staffed and we looked at the appointment records in respect of the ;last staff appointment and the relevant records are being held. The home told us in their Annual Quality Assurance Assessment that it hopes to involve residents in the selection and employment of new staff. We felt that staff in the home saw the needs of the residents as paramount and that they were working as a team with shared objectives. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is well run by a competent manager and he is well supported by the company by supervision through Stepping Stones. Evidence: The manager was seen as competent and providing good leadership for the staff in the home. It was evident that he was clear about the objectives of the home and his management style has resulted in an excellent relationship with staff and residents. The manager is seen by staff and residents as a approachable and is always prepared to stop and listen. The manager is supervised by a senior member of staff from Stepping Stones care home and he felt that this support was helpful and appropriate. We recommend that the registered manager is involved at all stages of any staff appointments. Regulation 26 visits are complected however the records were not available as they had been requested by the Company, we Will look at the reports on our next visit. Quality Assurance is being dealt with by regular surveys which are provided for residents and relatives. Equality and diversity issues are being addressed band cultural and religious preferences will be met. Health and Safety matters are given priority and staff were aware of the need to provide a relatively risk free environment. Are there any outstanding requirements from the last inspection? Yes  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, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action 1 20 13(2) Regular stock checks of PRN medications must be undertaken 31/05/2007 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 Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 1 4 The correct address of this 02/04/2009 Commission to be inserted in the Statement of Purpose and Service Users Guide To enable the Commission to be contacted 2 31 18 Support staff must be responsible for all communications with health care professional 27/02/2009 To protect residents from inappropriate acts or omissions 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 2 3 6 12 37 The home should ensure that care plans and the daily sheets have a related objective Activities should be formally reviewed to ensure individual preferences are considered That the registered manager is directly involved in all stages of staff appointments Helpline: 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 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. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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