Inspection on 18/10/05 for Riverside House

This inspection was carried out on 18th October 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 18/05/05

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 Watsfield Road Kendal Cumbria LA9 5JL Lead Inspector Marian Whittam Unannounced Inspection 18th October 2005 12:20 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 Riverside House DS0000036514.V255752.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 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 DS0000036514.V255752.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Riverside House Address Watsfield Road Kendal Cumbria LA9 5JL 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) 01539 773090 01539 773512 Cumbria Care Mr Rafal Stewart Szlachetka Care Home 34 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (11), Old age, not falling within any other of places category (23) Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. A maximum of twenty three older people (OP23) may be accommodated to include eleven 11 older people wth dementia (DE(E)11). When a single room of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users. The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Older Adults by 1st April 2004. To accommodate one named younger adult with dementia (DE1). Date of last inspection 18th May 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 and approximately a mile from the town centre and general amenities. The home is set back from the road overlooking the river and has its own private gardens and lawns. Riverside House is made up of four units, over three floors, served by a passenger lift. The units are named; Kentmere, Howgill, Farleton and Romney. All the bedrooms are single occupancy. The Romney unit provides short-term intermediate care in partnership with Social Services and the local NHS Trust, to help people return to their own homes as quickly as they can. Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place on 18thOctober 2005 over 5 hours. The inspector looked around the home and talked with 11 residents, some in groups and others in their bedrooms and with 4 members of staff and the supervisors. A number of records and policies and procedures were inspected and care plans and medication records. Medication administration practice was observed. What the service does well: What has improved since the last inspection? What they could do better: The home must meet requirements made at the last inspection regarding medication records, bringing staff training and development and profiles up to date and to make sure that residents are given the opportunity to have regular meetings to give their views on the service and the care they receives. Actions plans should be provided for this. Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 Page 6 It was not possible to assess what training staff had and what was needed as records were not up to date. Fire training records were poorly recorded and must be improved to make sure that all staff had received this at appropriate intervals. Staff could not find the complaints procedure during the inspection. The home must make sure that it is readily available for anyone who wants it and should be displayed. It would be good practice by the provider to make sure that residents are regularly asked their views on meals as there is a feeling among residents that the standard is not consistent. Staff rotas should be clear and legible. Numerous alterations on rotas meant that it was not easy to see which staff were on duty at any time and in what capacity. It should be made clear when agency staff are on duty. 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 DS0000036514.V255752.R01.S.doc Version 5.0 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 Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 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): 3 and 4 A detailed assessment and care planning system and information from other agencies was in place to provide staff with the information they need to meet resident’s needs when they come in. EVIDENCE: Individual care plans showed that new residents needs had been assessed before and following admission. A separate assessment is done by the home in addition to the social services care management plans. Where appropriate other care agencies and professionals had been involved in providing information and making assessments of the needs to be met. Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 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 and 10 The health and personal care needs of residents had been identified, set out in individual care plans and were being met for residents. Medication practices were generally satisfactory but some record keeping needed improve to safeguard residents and staff. EVIDENCE: All residents have an individual plan of care stating assessed health and personal care needs and risk assessments. These had been reviewed and updated, as individual needs changed, including a recent thorough review of moving and handling assessments. 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. This was evident for one resident with continence problems. Residents spoken with said that they felt they were well cared for and that their privacy and dignity was respected. One resident said that no one tried to make you do things you didn’t want to, that they felt safe and another that staff “take really good care of you when you’re poorly”. Residents said that they saw doctors and nurses in their rooms and that when they wanted a Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 Page 10 doctor one was called. One resident said they thought it was good that “you get your laundry back the next day” and that they always had clean clothes and underwear every day. There were medication policies and procedures in place to safeguard residents but practices for recording applications of prescribed creams and lotions to residents were still not satisfactory. A requirement was made on this at the last inspection. Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 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 and 15 Some organised activities and social events are being provided including one to one activities that take into account individual preferences. Choices about daily life and routines, contacts with family, friends and the local community are being promoted and maintained according to the residents recorded wishes. Special dietary needs are being catered for with therapeutic diets and a choice of food for the residents. EVIDENCE: The home provides some group and one to one activities and entertainments, social and religious events. Resident’s interests are recorded and individual abilities considered in planning and carrying out activities on the unit. The units recorded what individuals had done and these showed residents had enjoyed dominoes, music and armchair exercises. Entries showed that there had been times when staff were, “unable to provide activities” because there were “not enough staff”. Residents said that they could follow their own interests, listening to music and reading and some went for walks out with relatives, one to the races and another had been to a craft centre. Residents told the inspectors that they could choose to take part or not as they preferred and one said, “I like to keep myself to myself ” but said they enjoyed the singer that had been in the home. Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 Page 12 Residents said that they could come and go as they pleased, take their meals where they preferred, go out and have meals kept for them and see who they wanted to. Several of those spoken with thought the quality of the food provided was “very good”, another thought it was “ usually good, but you have to take the bad and the good” and a small number spoken with felt there had been times recently when the food was not as good as it had been. All spoken with said they were asked each day what they wanted from the menu. Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 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 and 17 A satisfactory complains procedure was not available or on display. However residents felt confident that the manager would listen to them and act on any concerns effectively. EVIDENCE: The complaints procedure was not available in the home and was not on display and accessible to residents and persons visiting the home. The complaints records were not available as the manager was not on duty but the supervisor confirmed that no new complaints had been received 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. One resident said of the manager “ he’s really good and I can talk to him”. One resident said that staff asked if everything was aright or if anything was worrying them and often asked if there was anything they wanted to talk about. Information on advocates and residents advice services from Age Concern was available. The home did not deal with any resident finances beyond holding small amounts of personal money for them to spend as they wished. Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 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 and 26 The home provided a clean, homely and adequately maintained environment for residents with a satisfactory standard of decoration in the home and equipment to promote their independence. EVIDENCE: The home is well maintained with planned maintenance and a satisfactory standard of decoration throughout that provides a clean, tidy and homely environment for residents. Several rooms had been redecorated and residents were pleased with this work and said that they liked their bedrooms. Residents had been involved in choosing new décor. Funding was being made available to provide a solution to the odours in one bedroom. Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 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): 27, 28 and 30 Recent staff shortages are slowly improving and minimum levels are being maintained using agency staff at times. Continued stability in the team will promote a more consistent standard of care for residents. EVIDENCE: Care staff said that staff levels have got better recently and things are “a bit more settled”. Staff confirmed, that agency staff have been used for some time to maintain the minimum staff levels especially on night duty. Staff rotas were difficult to follow due to repeated alterations and the use of agency staff could not be distinguished from permanent staff. The management team is now more stable and they are making progress in bringing areas of training up to date, moving and handling is one such area. Sickness levels and staff shortages have affected the homes progress in bringing some training up to date. The supervisor has planned how this is to be done, and this must be done quickly. A new staff member spoken with confirmed that they had induction training, fire training, were supervised when starting work and had been vetted by the Criminal Records Bureau. However there were no individual staff training records and profiles available for inspection to confirm this. Training information has not been drawn together into the continuous professional development plans for all staff. Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 Page 16 The home is continuing to enrol staff to do NVQ level 2 and is making progress towards meeting the minimum ratio. Staff confirmed that they are being supported to achieve this training. Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 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): 34, 35 and 37 Satisfactory procedures were in place to safeguard resident’s personal money. Fire training, drills and instruction given to staff needed to be recorded. EVIDENCE: There were no record of resident’s meetings having been held to give residents the opportunity to comment on the service and care provided. However 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 personally. Records of resident’s personal money and receipts of transactions were kept in secure facilities by the home, in good order and checked for accuracy by senior staff. The home has a business and financial plan in place and satisfactory insurance cover. Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 Page 18 Fire training records were not up to date and it was difficult to assess whether or not the appropriate training had been given to staff. Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 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 3 X X 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 Standard No Score 16 2 17 3 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X 3 3 X 2 X Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? YES 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 13 (2) Requirement Prescribed creams and lotions must be signed for on MAR charts when administered. (Previous timescale of 01/06/05 not met). A clear complaints procedure must be available in the home at all times. Individual training and development records and continuous professional development plans must be fully implemented and up to date. (Previous timescale of 01/07/05 not met) Moving and handling training and/or updates must be provided for staff and recorded. Residents must be given the opportunity to express their views on the service and the care provided through regular residents meetings. Records of fire training and drills must be kept up to date. Timescale for action 30/10/05 2. 3. OP16 OP30 22 18 (1) 30/10/05 31/12/05 4. 5. OP30 OP33 13 (5) 24 (1) (3) 31/12/05 30/10/05 6. OP37 17 (2) (3) 30/10/05 Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 Page 21 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 OP15 OP27 Good Practice Recommendations Residents should be consulted on their opinions of the meals provided. It should be possible to determine from the staff rotas who is on duty at all times and their status. Agency staff should be marked clearly. Riverside House DS0000036514.V255752.R01.S.doc Version 5.0 Page 22 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 DS0000036514.V255752.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!