Inspection on 18/05/05 for Riverside House

This inspection was carried out on 18th May 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Riverside House 24/07/07

Riverside House 26/04/06

Riverside House 18/10/05

Riverside House 01/02/05

Riverside House 31/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Riverside House Wattsfield Road Kendal Cumbria LA9 5JL Lead Inspector Marian Whittam Announced 18 May 2005 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Riverside House Address Wattsfield Road Kendal Cumbria LA9 5JL 01539 773090 01539 773512 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Cumbria Care Rafal Stewart Szlachetka Care Home 34 Category(ies) of OP - Old Age registration, with number DE(E) - Dementia - over 65 of places DE - Dementia Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 2. A maximum of twenty three older people (OP23) may be accommodated to include eleven 11 older people wth dementia (DE(E)11). 3. The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Older Adults. 4. When a single room of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users. 5. To accommodate one named younger adult with dementia (DE1).. Date of last inspection 1 February 2005 Brief Description of the Service: Riverside House is a home caring for 34 older people, including 11 residents with dementia and is in a residential area on the outskirts of Kendal town centre. The home is set back from the road overlooking the river and has its own private gardens and lawns. It is owned by Cumbria County Council and run by Cumbria Care. Riverside House is made up of of four units, over three floors, served by a passenger lift. The units are named; Kentmere, Howgill, Farleton and Rowney. All the bedrooms are single occupancy. The Rowney unit provides short-term intermediate care in partnership with Social Services and the local NHS Trust, to assist residents to return home after short stay in the home. Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place on 18th May 2005 over 7 hours. The inspector looked around the home and a number of records were inspected. Twelve of the thirty-four residents, four of the staff and one visitor were spoken with. Residents were spoken with individually in private and in groups in the lounges. What the service does well: What has improved since the last inspection? Records showed that formal staff supervision was now in progress and staff confirmed the value of this. The reviewing and bringing up to date of care plans has improved so that information and instructions to staff are current and reflect residents changing needs. The staff files had been improved to include relevant information and criminal record checks to safeguard residents. Redecoration of areas of the home and the replacement of old furniture in the home is underway adding to the homely environment. Further improvements are planned. Residents were pleased with the improvements. The return of the permanent manager and a more settled senior staff group has provided more stability for staff and residents and allows better supervision and support in the home. Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 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 F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 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 standard(s) 2,3,4, 5 and 6 Adequate information was available to prospective residents about the home and an assessment and care -planning system was in place to provide staff with the information they need to satisfactorily meet resident’s needs. There was dedicated accommodation and staff, with specialised facilities to deliver short term rehabilitation to enable people to return to their own homes. EVIDENCE: Clear and up to date information was available in the home for prospective residents and their families and terms and conditions of residency were given to residents at admission. On the day of the visit a prospective resident was looking around the home with a relative and talking with staff and other residents. However a resident with sight problems had not been able to get much information before coming in because it had been written down. Alternative formats to suit intended residents capabilities should be considered if all residents are to be able to make a fully informed choice. Individual care plans showed that new residents needs had been assessed before and following admission. The home manager did an individual Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 9 assessment in addition to the social services care management plans that were held on file. The six bed intermediate care unit has its own clear care plans and records developed with other services. It has its own entrance and communal space and the 2 people staying there said they felt the service was helping them get back home. Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 10 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 standard(s) 7, 8 ,9 and 10 The health and personal care needs of residents were being identified, stated in individual care plans and were being met for residents. Medication practices were generally satisfactory however improvement to some record keeping was needed to safeguard residents and staff. EVIDENCE: All residents have an individual plan of care setting out health and personal care needs and risk assessments that had been reviewed and updated, as individual needs changed. Care plans were being put on to the computer which would make it easier to review and make changes in the plans to keep staff well informed. Healthcare needs were being identified, planned for and met and there was good working relationships with other healthcare agencies, to assess, identify and help manage individual problems. Residents spoken with said that they felt they were well cared for and that they were treated with proper respect by staff . Residents said that they saw personnel from health care services in their own rooms when they needed to. Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 11 There were medication policies and procedures in place to safeguard residents but practices for recording applications of prescribed creams and lotions to residents were not satisfactory. Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 12 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 standard(s) 12, 13, 14 and 15 The home has a limited programme of daily social activities and staff supported residents to make choices about their daily life. However there was little coordination of the available activities to meet individual preferences and capabilities or meet particular individual needs. Menus in the home offered a choice of food but more consultation was needed to get residents views on the food provided and what they would like to see on the menu. EVIDENCE: The home provided some daily activities, recorded resident’s hobbies and interests and organised social and religious events. On the day of the visit there was a fashion show in one of the lounges. Residents said that they could come and go as they pleased and see who they wanted to. One resident spoken with was going out with a friend for the afternoon and another had already been out to visit their sister that morning. No one person in the home coordinated what activities went on or if they suited resident’s preferences, needs and capabilities and this fell to staff on duty on the different units in addition to their main job as carers. Residents told the inspector that the home used to have a carer who organised the activities and took them out into the garden, and she had been very good, but Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 13 since she had left no one had taken this job over. If residents are to know in advance what activities are being provided and in order to have activities that suit their preferences and abilities, someone should oversee and review activities on offer. Residents spoken with made a range of comments about the food in the home, Several of those spoken with did not think the quality of the food provided was good, some others thought it was “ alright” and a small number spoken with felt the food was good. One said that, “they should spend more money on it and have more variety, build you up a bit”. All agreed there was a choice of food each day and that there was plenty to eat and drink. The menus provided showed a nutritious diet with fish, meat and vegetables, milk and cheese dishes, although little fresh fruit, with lunch as the main meal. The home should consult with the residents to get their views on the food and what kind of things they would like to see on the menu. Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 14 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 standard(s) 16,17 and 18 The home has a satisfactory complaint system that both residents and staff were aware of. Residents felt confident that the manager would listen to them and act on any concerns effectively. Staff were aware of Adult Protection processes, the procedures in place and had received training and information on this to safeguard residents from abuse. EVIDENCE: The home has complaints procedure and logged formal complaints for investigation and the procedure was available to residents. There had not been any complaints since the last inspection. Daily matters raised were noted in the comments book for action. Residents spoken with were confident that the manager would take their complaints or concerns seriously and deal with them. Information on advocates was available and some residents had these to act on their behalf. There were procedures in place to protect vulnerable adults and for whistle blowing including multi agency guidance. Staff had been given training on adult protection procedures and the different kinds of abuse and those spoken with were clear what they would do. The home had procedures in place for dealing with verbal and physical aggression and also on handling residents money. The home did not deal with any resident finances beyond holding small amounts of spending money for them to spend as they wished. Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 24, 25 and 26. The standard of décor in the home was satisfactory overall with evidence of recent improvements and more planned. The home provided a clean, homely, adequately maintained and comfortable place for residents to live with the equipment they need to promote personal needs and independence. EVIDENCE: Some rooms in the home had been redecorated and new bedroom furniture, armchairs, dining tables and commodes had been provided for residents, improving their environment and comfort and the homely appearance of communal areas. The dining and lounge areas on the units were seen being used for activities. Residents were pleased with the improvements in their home. Changes were planned to provide a separate room for smokers to improve communal facilities for residents. Resident’s bedrooms seen by the inspector had satisfactory standard of décor and many had new furnishings. Many rooms had residents own possessions and this made them more personal and homely for residents living there. Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 16 The home was clean and tidy. There is a range of equipment and adaptations in the home to help residents make the most of their independence and to get about the home. Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 There has been limited progress in improving staff shortages and there are times when a minimum level of staff has not been maintained and this has a detrimental impact on providing a consistent and safe standard of care for residents. The procedures for the recruitment of staff are satisfactory and offer protection to people living in the home. Staff training was established in the home and induction and foundation training provided to promote a competent staff group to care for residents. EVIDENCE: There had been a lot of staff changes over the last year and there had not been full senior team in place until recently and the home still had difficulties with recruitment. Although rotas were difficult to follow days could be identified when staff levels had been inadequate. The rotas should be easily understood and show clearly which staff are on duty and what job they are doing. On the day of the visit a minimum level of staff on the late shift could only be maintained if the supervisor worked as a carer. The supervisor had then to fulfil different roles whilst on duty, provide support and direction for staff and be available for residents and visitors. This had been the case on other occasions and the home had also used agency staff to provide some cover. If resident’s needs are to be properly and safely met then there must always be sufficient numbers of staff on duty with appropriate skills and experience to fulfil their roles. The home had recruitment procedures in place and the inspector looked at the files. The home had followed procedure and undertaken all the necessary Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 18 checks to protect residents. However the files needed to have photographs of staff working in the home as part of proof of the person’s identity. The home had individual training records and had made progress on developing these but these were not always updated. The manager must draw all the training information together and record all training and fully implement the continuous professional development plans for all staff to enable them to meet the homes aims and meet residents changing and different needs. Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36 and 38 The manager has a clear development plan and vision for the home, which he has effectively communicated to residents and staff. This results in clear leadership in the home with staff demonstrating an awareness of their responsibilities. This results in practices that promote the best interests of residents and safeguards their health and welfare. EVIDENCE: The manager was clear about his role and had a good working relationship with staff and residents. Staff spoken to felt supported by the management team and that the home was “more stable” with a permanent manager again. Residents made generally positive comments about the staff team. One resident said they were, “constantly amazed by the kindness and patience” of the staff. Formal staff supervision was in progress; regular staff meetings and staff questionnaires allowed staff feedback, along with internal reviews and Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 20 information sharing. Residents said that they saw the manager most days, said he was, “very good” and felt happy to raise issues with him and get their views across. However regular residents meeting had fallen behind and these must re start to ensure that resident’s views and opinions are formally sought and acted upon. Satisfaction surveys should be collated and published. The manager had started the NVQ level 4/Registered Managers Award but this was not completed and this should be restarted and completed. Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 x 3 3 3 STAFFING Standard No Score 27 2 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 3 2 x x 3 x 3 Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 22 YES 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 OP9 Regulation 17 (1) (a) Schedule 3 18 (1) (a) Requirement The administration of prescribed creams and lotions must be signed appropriately on the MAR at the time of administration. At all times there must be sufficient numbers of competent and experienced staff in the home to meet the health and welfare needs of residents. A recent photograph of persons working in the home must be kept on file. Training and development records and continuous professional development plans must be fully implemented and up to date. Residents meeting must be re started to allow residents a forum for expressing their views. Timescale for action 1.6.05 2. OP27 1.6.05 3. 4. OP29 OP30 19 (4) Schedule 2 18 (1) 1.6.05 1.7.05 5. 6. OP33 24 (1) (3) 1.7.05 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 F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 23 Riverside House 1. 2. 3. 4. 5. 6. 7. OP1 OP9 OP12 OP15 OP27 OP30 OP33 The service users guide should be in formats suited to the intended resident. Controlled medication being returned to the pharmacy should be acknowledged as received. Someone should coordinate the activities programme to make sure it went ahead and met residents expectations and abilities. Residents views on and suggestions for the food provided should be sought. Staff rotas should be clear and legible and show which staff are on duty and in what capacity. The manager should complete the NVQ4/ RMA . Satisfaction surveys should be published and made avaiable. Riverside House F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP 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 F58 F10 s36514 riverside house v214878 180505 ai stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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