Inspection on 26/04/06 for Riverside House

This inspection was carried out on 26th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 18/10/05

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 Wattsfield Road Kendal Cumbria LA9 5JL Lead Inspector Mrs Margaret Drury Unannounced Inspection 26th April 2006 10:20 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.V289151.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Riverside House Address Wattsfield 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 www.cumbriacare.org.uk 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.V289151.R01.S.doc Version 5.1 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 with dementia (DE(E)11). The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Older Adults by 1st April 2004. When a single room of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users. To accommodate one named younger adult with dementia (DE1). Date of last inspection 18th October 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. The home provides a statement of purpose and terms and conditions that give any prospective resident and/or their families details of the facilities on offer. There is also a copy on display in the hall. The fees in this service range from £317.00 - £422.00 per week as at April 2006. There are extra charges for Chiropody (£15.00), hairdressing (£8 - £22) newspapers, toiletries and taxi fares. Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection that took place over one day on the 20th April. The registered manager was on duty on the day of the inspection and was available to assist the inspector. During the inspection, time was spent talking with the manager, the supervisors and care staff on duty. The inspector also spent time looking at records to do with the day-to-day running of the home and the care of residents. The report refers to “case tracking”, a process by which the inspector is able to focus on a small number of residents and includes a review of their care documentation. It should be noted that this process is not detrimental to the other residents living in the home Time was spent with some of the residents individually and in groups, and some parts of the home were looked at. What the service does well: What has improved since the last inspection? Most of the requirements that were made at the last inspection have been met. A programme of residents’ meetings has been planned and medication records are now completed in full. A copy of the complaints procedure is now on display in the hall and all fire safety records have been brought up to date. Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5 & 6 Quality in this area is good. This judgement has been made using the available evidence including a visit to this service. Prospective residents and their families are given the opportunity to visit the home.All residents are given a statement of porpose, contract and terms and conditions. Admissions to the home are not made until a full assessment of needs has been completed to ensure all the assessed needs can be met. The residents in the intermediate care unit are supported to ensure they regain sufficient independence to allow them to return to their own homes. EVIDENCE: Case tracking was undertaken for 3 residents. This involved checking the case files and care plans. The case files evidenced that the residents had all been properly assessed prior to admission and there was a copy of the admission held on file. All the care plan reviews were up to date with any changes noted in agreement with information on the daily record sheets. All risk assessments were in place with the reviews carried out on a regular basis. Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 Page 9 Prospective residents and/or family members are given information about the home and there is also a copy of the statement of purpose and last inspection report on display in the hall. All residents files contained a copy of the community care agreement and terms and conditions. Discussions with a visitor during the inspection evidenced that family members are able to view the home as often as they wish before any resident is admitted. Discussions with the registered manager, staff and residents in the intermediate care unit showed that all those who came for intermediate care were assisted and encouraged to regain and retain sufficient independence to facilitate their return home. Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 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 the following standard(s): 7,8,9 & 10 Quality in this area is good. This judgement has been made using the available evidence including a site visit to this service. All residents have a plan of care that is reviewed regularly involving residents and/or their families wherever possible. These are reviewed and the necessary action taken to respond to any changes deemed necessary. Healthcare needs are met by healthcare professional services that are available when required. The home works to an efficient medication policy with staff following the procedures to ensure the records are kept up to date. The home considers treating the residents with dignity and respect to be important. EVIDENCE: Case tracking was undertaken in respect of 4 residents. Care plans and daily records were checked to ensure the care plan reviews agreed with the daily care records. In all cases they did, showing that the information contained in the daily records was reflected in the care plan reviews.The daily record evidenced that healthcare needs were met by imput fron the local healthcare professionals. This was confilmed by discussions with the residents who all agreed that their doctors visited on request and the services of the district Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 Page 11 nurses were available on request. Medication records were examined and found to be up to date and correctly completed. The inspector dicussed the incident of the non-recording of prescribed lotions and creams with the manager. This has now been addressed and the inspector was able to check these records. Discussions with the residents evidenced that they felt their needs were met in such a way that their privacy and dignity were respected at all times. They all spoke highly of the staff and told the inspector that they were a good lot of girls who could not do enough for you.The inspector noted that all personal care was given in the privacy of the residents bedrooms. The requirement made at the last inspection in respect of medication records has been met. Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 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 the following standard(s): 12,13,14 & 15 Quality in this area is good. This judgement has been made using the available evidence including a site visit to this service. The home tries to be flexible and every effort is made to provide an individual service within the staffing levels available. The home works to open visiting arrangements and visitors are made welcome. The food in the home is of good quality but can vary depending on who is preparing the meals. EVIDENCE: All residents are allocated a key worker and the inspector was able to speak with one who was on duty during the inspection. Interviews with residents and case tracking indicated that the residents were happy with their daily routines and the choices given about how they wished to spend their day. Residents meetings are now organised, giving those who wish, the opportunity to have their say about the running of the home. The home provides some group activities but no outings have been organised for this year as yet. The manager is making arrangements for one of the newer residents to potter about in the garden, as this was a hobby he enjoyed at home. Residents said they could join in the activities if they wished although some of them said they also enjoyed the privacy of their own room or just having a chat with their friends. Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 Page 13 All the residents who spoke to the inspector said that they enjoyed their food although one resident indicated that sometimes it depended “who was doing the cooking”. Agency catering staff are sometimes used and this is not the most ideal situation. Observations during the lunch period indicated that the meals were served and taken in a relaxed atmosphere. Changes in the weekly menus have recently been discussed at residents meetings. Arrangements are in place to appoint a new cook. Residents are encouraged to maintain contact with their families and visitors in the home during the inspection said they were always made very welcome. Local clergy make visits to the home and Communion is available to any resident who wishes to take it. One resident is able to attend the local Anglican Church. Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 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 the following standard(s): 16 & 18 Quality in this area is adequate. This judgement has been made using the available evidence including a site visit to this service. The home uses the corporate complaints procedure which meets the National Minimum Standards. Residents and visitors understand the procedure to follow. All staff interviewed showd an awareness of adult protection issues and the policy to follow although further training in subject would be beneficial. EVIDENCE: Interviews with the residents and visitors confirmed that although there was not, until recently, a copy of the complaints procedure on display they all knew the procedure to follow and were confident that any concerns they raised would be dealt with and acted upon in a timely manner. There are some adult protection training videos available for staff to access and this subject is covered during the NVQ training. Elder abuse is also covered during the staff induction programme. Staff who were interviewed during the inspection showed an awareness of abuse issues and the procedure to follow should action be necessary. Further staff training in this subject would be beneficial to residents and staff. Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 Page 15 Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 Page 16 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, 21, 22, 24 & 26 Quality in this area is adequate. This judgement has been made using the available evidence including a site visit to this service. The service provides a homely environment but there should be a better programme to improve the internal decoration.Residents can personalise their rooms but they mainly stay in the same communal area during the day. The home is well lit, clean and tidy and smells fresh although there are domestic staff vavancies. EVIDENCE: The home is reasonably well maintained with many of the residents rooms recently redecorated. There is a maintenance programme that is overseen by the organisation’s head office working within the constraints of the annual budget. There are sufficient bathing and toilet facilities to meet the assessed needs. Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 Page 17 Most of the rooms are small but the residents who spoke to the inspector were happy with their accommodation, particularly those with en-suite toilet facilities. The communal areas were well lit and all the lounge chairs have been replaced over recent months. All the bathrooms are suitable for people with a disability and there are hoists and rails on the corridors to assist with movement around the home. The home was clean but there are vacancies for domestic staff, a situation that should be addressed as soon as possible. Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 Page 18 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, 29 & 30 Quality in this area is adequate. This judgement has been made using the evidence available including a site visit to the service. The home uses the corporate recruitment procedure that clearly outlines the process to be followed. The annual staff training programme encourages staff to improve their skills and knowledge. Residents in the home have confidence in the staff to care for them. EVIDENCE: Discussions with the manager revealed that there are, currently, a number of staff vacancies resulting in the use of agency staff. The residents also remarked on this when speaking with the inspector. This has resulted in times when the staffing levels differ during the day, particularly in the afternoon and evening. The inspector examined the staff rota and found that this was so although the rotas now indicate which staff on duty are those from the agency. Extra hours were made available for checking medication and it is important that these continue to be used for the benefit of the residents and the running of the home. A recent complaint regarding the number of staff on duty during the shifts was investigated and upheld. The manager is in discussions with his line manager in an effort to resolve the situation and ensure the staffing rotas provide sufficient staff to accommodate the residents and meet the assessed needs. Particular attention should be given to the recruitment of night staff to fill the current vacancies. This would ensure that agency staff would not be required to work night shifts. Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 Page 19 The home works to a corporate recruitment policy that ensures all the required checks are completed before any new staff start work. All the staff files that were examine contained all the documentation required to meet the National Minimum Standards. Training and professional development records have not yet been brought up to date although some training has been completed. Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 & 38 Quality in this area is good. This judgement has been made using the available evidence including a visit to this service. The manager is competent to run the home and ensure it is operated in the best interest of the residents. The home has sound corporate policies and procedures in place that are regularly updated. Financial procedures are in place to safeguard the residents’finances. The home works to a clear health and safety policy with internal audits undertaken to ensure the standards are met. EVIDENCE: Discussions with the manager during the inspection evidenced that he works hard with the staff team to provide a high level of care and support to the residents. The residents spoke highly of him and the fact that he was very Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 Page 21 approachable and nothing was too much trouble. The residents personal finances are safeguarded by a suitable system for recording monies received and spent, with all receipts held on file. Each record entry showed two signatures and the home’s operations manager regularly audits the records. There are annual health and safety audits completed by the organisations health and safety officer and all policies and procedures are provided and kept up to date. All residents’ risk assessments were up to date and reviewed regularly. Staff supervision is not quite up to date and this should be addressed as soon as possible. All equipment in the home is checked on a regular basis via annual contracts and fire records are now up to date. Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 Page 22 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 3 3 3 X 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 3 X 3 X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 Page 23 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 OP30 Regulation 18 (1) Requirement Individual training and development records and continuous professional development plans must be fully implemented and up to date. (Previous timescale of 01/07/05 and 31/12/05 not met) All staff vacancies must be filled as soon as possible to avoid consistent use of agency staff Timescale for action 30/06/06 2 OP27 18 30/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Riverside House DS0000036514.V289151.R01.S.doc Version 5.1 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 DS0000036514.V289151.R01.S.doc Version 5.1 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. 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. 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