Inspection on 29/04/08 for Riverside House

This inspection was carried out on 29th April 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Riverside House Low Stanners Morpeth Northumberland NE61 1TE Lead Inspector Janine Smith Key Unannounced Inspection 10:15 29th April 2008 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 DS0000070972.V356915.R01.S.doc Version 5.2 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 DS0000070972.V356915.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Riverside House Address Low Stanners Morpeth Northumberland NE61 1TE 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) 01670 503103 01670 503103 Southern Cross BC OpCo Ltd Application in progress Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46) of places Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 46 The maximum number of service users who can be accommodated is: 46 26/9/07 2. Date of last inspection Brief Description of the Service: Riverside House provides a home for up to 46 older people who require residential care. Nursing care is not provided. The building is large with a ground and upper floor. It has a passenger lift. All of the bedrooms are single and have an en-suite toilet and shower. There are also four separate bathrooms. There is a pleasant garden area and ample car parking spaces. The home is a short walk away from Morpeth town centre and therefore close to most of the amenities the town has to offer. Buses provide the main means of public transport. Information about the service, including inspection reports, is readily available. Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit on 26th September 2007. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 29th April 2008 and a further visit on 30th April 2008. During the visit we: • • • • • Talked with ten people who use the service, a relative, nine staff and the manager. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building/parts of the building to make sure it was clean, safe & comfortable, Since the last inspection, the ownership of the home has changed to Southern Cross BC OpCo Ltd. The previous manager has also resigned and the new manager, Mrs Michelle Daglish, has applied for registration with CSCI. What the service does well: People considering moving into this home are given time and good information to help them decide if the home will meet their needs. Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 6 Residents’ health care is looked after well and staff respect residents’ privacy and dignity when assisting them. Residents made very positive comments about the care they receive from the staff team, such as: ‘The staff are very good and I wouldn’t want to go anywhere else’. The staff are ‘very, very kind and caring’. A relative who completed a survey said, ‘my relative….recently had significant problems eating. Riverside were exceptionally persevering with preparing meals specially to encourage her to eat. Also they consulted the primary health care team regularly’. The home employs committed and caring staff. Excellent work has been carried out to expand the range of social activities. This has led to residents’ having more contact with the local community as well as helping them to try new skills and experiences. A relative who completed a survey said, ‘my relative has depression and dementia. Riverside always ensure that she is invited/included in all activities. I have been very pleased that in the past six months, she has become more engaged with other residents.’ Relatives who completed surveys made the following comments about things that are done well: ‘Individual carers are skilled and caring’ ‘Occupational therapy, trips out, meals’ ‘Diversional therapy. Visitors are always made welcome’. ‘Regular meals, medication, friendly supportive staff. A range of activities are provided and (my relative) has been encouraged to participate’ ‘Provides a homely caring environment. We have always found the staff to be very good. My (relative) has been consistently positive about the home and the staff’. What has improved since the last inspection? Since the new manager took up post and the takeover by Southern Cross, staff training has been made a priority and a number of training courses were underway with more planned. The home has had some refurbishment of communal areas and this will continue. Replacement of bedroom furniture and carpets is ongoing. Staff photographs are on display in the foyer area so residents and their families know who they are. Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 7 A plan of care is put in place when new residents are admitted to the home. The handling and storage of medication has been improved, which helps ensure the safety of residents. What they could do better: Residents have the right to control their own medication and where they wish to do this, a risk assessment should be carried out to identify any concerns and measures that can be put into place to reduce the risk of harm to the resident or anyone else. The temperature of the medication storage area should be checked regularly to ensure that medications are stored at a suitable temperature. This will ensure they do not deteriorate. Whilst residents have en-suite showers, it is not clear if all of these are working or are suitable for them. Some of the assisted baths are not in working condition and need to be repaired or replaced as soon as possible. Training for care staff about the prevention of falls will help them to put more effective care plans in place. This will help protect residents who at risk of falls. The availability of suitable hoisting equipment in the home should be reviewed. This will ensure that residents are not kept waiting for unreasonable periods of time when they need assistance with personal care for which a suitable hoist is needed. Changes in the seating arrangements in the main ground floor lounge have led to increased disagreements between some residents and caused some residents to feel unsafe. Residents should be asked for their opinions about the seating arrangements in the main lounge area. Efforts should be made to accommodate these where possible, ensuring that their health, safety and wellbeing is safeguarded. This should help residents to feel more ‘at home’ and more in control of their living environment. Some residents feel that the new manager is not very approachable and feel that she is always too busy in the office, which means they do not feel readily able to share their opinions. Alternative ways of enabling residents to get to know the new manager need to be found, which will help ensure that they feel able to tell her their opinions and concerns and promote an open, inclusive atmosphere in the home. Please contact the provider for advice of actions taken in response to this Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 8 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 9 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 DS0000070972.V356915.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People considering moving into this home are given time and good information, which helps them decide if the home will meet their needs. EVIDENCE: The home’s Statement of Purpose and a Guide for Service Users were openly displayed in the foyer. The care records of two service users admitted within the past year showed that information had been gathered about each person’s needs and then used to draw up a care plan. A visitor said that they had chosen this home for their relative after looking at several others. He confirmed that a senior member of staff had visited their relative before admission to discuss her needs and what she needed help with. Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 11 They said they had received plenty of information about the home, including what fees would be charged. He said his relative had received good care since moving into Riverside House. Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Four service users’ care records were looked at. Assessments are carried out regularly to determine the risk of falls, pressure ulcers and malnutrition. The information from these assessments was generally used well to draw up comprehensive care plans. However, care plans for the prevention of falls are narrow in scope, focussing on obstacles, rather than taking account of wider factors such as effects of medication, visual impairment, etc. Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 13 Care staff monitor the skin condition of service users and seek professional advice about this when necessary. Pressure relieving equipment is provided through the Community Nursing Services for those service users at risk. Specialist equipment is available to help those residents who have difficulty moving independently. One resident said this equipment helped her feel safe when standing up. Another commented that it would be better if there was a hoist available on each floor, as she sometimes has to wait for assistance until the hoist is free. Service users spoken to confirmed that they have regular check-ups from opticians and dentists. They also said that doctors were always sent for, if they were unwell. A visitor said the staff looked after their relative well. Positive comments were received from residents spoken to during the inspection, such as: - ‘I like it here’, ‘the staff are very good and do everything they can to help you’, ‘the staff were very good and very caring’, ‘when you’ve lost your home, this is a good place to be’. Two said one particular member of staff was very helpful and someone who ‘you can tell your troubles too’ and another praised two other carers who made her laugh. Residents seen during the inspection were well groomed and staff were respectful of their privacy and dignity. One relative who completed a survey said their relative ‘more often than not is unshaved when I visit, often with more than one day’s growth’. Two of the residents said that staff always respected their privacy and dignity, one saying that staff always knocked on the bedroom door before coming in. The medication systems were inspected earlier this year, at which time some issues were identified as needing improvement. The system for storage, handling and administration of medication was looked at again on this inspection. It was found to be generally in order, except that the temperature of the main medication storage area was not being checked regularly. A risk assessment had not been documented where it was considered unsafe for a resident to look after their own medication. A senior carer confirmed that she had received training in safe handling of medication and evidence of training was seen on another senior carer’s staff record. Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 14 Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A very good variety of social and cultural activities are organised, which are helping residents to develop new skills and be involved with their local community. Residents are offered choices in food, activities and their daily lifestyles. EVIDENCE: The home employs a Diversional Therapist, who helps organise and plan social activities. The care staff also organise activities. A ‘Friends of Riverside’ group, comprising 3 residents and 3 family members, has been established. The group has received a grant of £10,000. They are using this to buy computers and other equipment and are recording residents’ life histories, if they wish to do this. A resident was seen looking at photos of her wedding on the computer and enjoying this. Some residents are showing interest in using email and a digital camera. The involvement in this project has led onto residents and children from a local school meeting and sharing life experiences. There has also been involvement with a local church and Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 16 residents were involved in a project to improve their environment. A Riverside choir concert had also been held, which had revealed some residents had skills in singing and playing instruments. Residents are running their own bingo group and one resident acts as bingo caller, which he enjoys. There are other regular activities such as music and art therapy, which some of the residents thoroughly enjoy. There are regular outings and visits by entertainers. Residents and a visitor said that relatives and friends were welcomed into the home. Residents choose when they want to get up and go to bed. Staff described how they gave people choices about when they wanted to go to bed or get up in the morning. They also choose whether they want to participate in the social activities. Mixed views were received about the food. Three said the food was good and there was lots of choice. One added that the cook knew his personal likes and dislikes, and catered for these. Two more said that the food was very good and there was plenty of choice. One said the food was not as good as it used to be because it is too cold when served, and there was too much pasta and sweet corn used. Another said it could take a long while before lunch was served. They said if staff were better trained they would be able to serve and clear the tables much quicker and that not enough fresh vegetables were served and there was too much sweet corn used. Another said the food was ‘terrible’ because it was ‘badly cooked and cheap and nasty’. A service user who completed a survey said ‘the menus are very repetitive and desserts, milk puddings, cake with custard, yoghurt or ice cream, no stewed fruit or home made pudding, but bought cheesecakes or gateau, which are delicious’ (sic). Both service users who completed a survey felt that cost factors had led to a decline in the quality of food provided. Lunch was observed. Staff were very attentive and residents were offered the menu choices at the point of the meal being served, which is good practice. Residents were given a choice of fruit drinks and tables were set with cutlery, condiments and fresh flowers. The carers assisted residents when it was needed. Residents were offered a choice between gammon or quiche with vegetables. Two residents sitting on different tables were heard to say that the meat was ‘lovely and tender’. There were plenty of stores and a supply of fresh fruit and vegetables and whole milk is obtained. The cook was aware who needed special diets and described the methods she used to fortify foodstuffs for residents who were undernourished. Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse and there is an effective complaints procedure in place. EVIDENCE: The complaints procedure was displayed and easy to understand. The manager said that two complaints had been received since the ownership of the home changed. One was about seating arrangements in the main lounge area and one about a short delay in handing over a personal allowance. Residents spoken to were aware of the change of management of the home and said they would raise any concerns with the manager if they had any. Two service users who completed a survey said they knew how to make a complaint. A relative who completed a survey said, ‘the manager encourages us to contact her if any problems or queries’. One resident said that she often chose to sit in her room now rather than the lounge because some residents argued over chairs and that these arguments sometimes led to some residents threatening others, which she found frightening. Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 18 The manager and staff seek advice from other health professionals where any resident presents verbal or physical aggression and staff described how they dealt with any situations that may arise. Some staff have had training about dealing with challenging behaviour. Staff are currently being given updated training about the protection of vulnerable older people. Staff spoken to were aware of what they must do if they have any concerns that a resident may be abused. Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, 25 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some of the layout and facilities in the home mean that it cannot be ensured that residents live in a safe, well maintained and comfortable environment. EVIDENCE: The home was toured. Each resident has a single bedroom with an en-suite toilet and shower. There are some signs of wear and tear in the building, with corridor carpets and some wall coverings looking worn and stained. A relative commented in a survey, ‘carpet in (relative’s) room tatty, chest of drawers falling apart’ and another said ‘corridor carpets are very worn and should be replaced’. Some refurbishment has taken place including the replacement of some bedroom furniture and carpets. A hairdressing room has been created which is attractive. The garden is to be improved. Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 20 There is a large well-used communal lounge with attached conservatory on the ground floor and a smaller lounge, in which several residents were enjoying watching the ‘Three Tenors’ on the television. Another ground floor room is used for activities. There is a further lounge on the first floor, which was being used for staff training on the day of inspection. A number of residents like to sit in the lounge, which is close to the main door and the office, and see what it is going on. Recently the seating arrangements in this area have been changed. Following discussion with people in the home, it seems this has led to more disagreements between residents and could lead to residents’ safety being compromised. A relative who completed a survey said the removal of chairs has ‘resulted in the residents arguing over the chairs, sometimes trying to bribe people to give up their seats. The less mobile residents are sometimes left on their own in the other lounges, unable to attract attention when they need assistance and being left socially isolated.’ There is only one communal bathroom in use now. One bath was broken and unusable. The manager said they were looking into the possibility of turning this into a wet room. The manager said that parts were on order for the first floor bathroom. Residents have en-suite showers but the manager said these were not very big. One resident said that her en-suite shower had not been working for several months, despite attempts to fix it, and this was not satisfactory. The laundry assistant said the industrial dryer was broken which is causing some delay in laundering items, but that parts were on order and the manager was to buy a new smaller dryer as a standby for the future. In the meantime, items were being bagged up and sent to another care service to be dried. The passenger lift was in working order. The premises were accessible. Lighting was adequate and the home was very warm. The home was clean and smelled pleasant. A cleaner described the tasks she carries out routinely. The laundry assistant described her duties. Both had protective clothing available to them and had received training about using potentially hazardous cleaning substances. One service user who completed a survey said ‘the cleaning staff are not really able to cope with the amount of work and should be increased’. Another said, ‘Lack of cleaning staff on occasions. Additional staff needed to cover for absence. The carpet in the corridor leading to rooms 64-77 is in a deplorable condition – requires replacement or professional cleaning’. A relative who completed a survey said, ‘cleaning and hygiene is good’. Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff team are very caring, kind and employed in sufficient numbers. Training is being improved, which will help them to support the people who use the service more effectively. EVIDENCE: There were 38 residents living in the home, and a new admission took place during the inspection. Discussion with the manager, staff and examination of the rotas showed that the home is currently staffed as follows: 8 am to 8 pm 5 8 pm to 8 am 3 The above includes a senior carer. The manager stated that the number of care staff would be increased, as occupancy of the home increases. Carers spoken to said that the number of care staff on duty was generally adequate although they could be busy at times. They said that they had time available to talk with residents although more time would always be useful. Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 22 The manager works 9 am to 5 pm Monday to Friday and other times as needed. Domestic, cleaning and laundry staff are also employed, as well as a diversional therapist, handyman and part-time administrator. The manager said that staff turnover had been high, but was now settling down. A number of temporary staff had been used from time to time when necessary. All of the residents who made comments during the inspection said they were treated well by the staff and that they were very caring. A relative who completed a comment card said, ‘the care home seems short staffed at times and sometimes the staff seem very tired due to working additional shifts’. 27 of the care staff had completed a National Vocational Qualification (NVQ) at Level 2 or 3. Since the manager took up post, more staff have been signed up for the NVQ and she has arranged a lot more staff training, including moving and handling, fire safety, protection of vulnerable adults, falls awareness, continence, dementia and low vision. On the second day of inspection, some staff were receiving training in food hygiene, fire safety and safe use of bed rails. A carer confirmed she had started an NVQ3 and had received other relevant training. Evidence of NVQ training was seen on two of the staff records viewed. The files of three staff recruited in the past year showed that appropriate vetting checks had been carried out. A recently recruited carer confirmed that vetting checks had been carried out before she was employed. Two had no previous experience of this work and there was documentary evidence that induction training had begun but was not fully completed. One confirmed that induction training was taking place and an experienced carer shadowed her, until she felt comfortable with the tasks required. A member of staff who completed a survey said, ‘the new manager ensures all new staff are receiving their induction prior to their job starting’. Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Following a period of considerable change in the ownership and management of the home, good progress has been made in implementing new policies, procedures and improving staff training. Further improvement can be made if more is done to ensure that residents are more effectively consulted and involved in shaping the way the home is run. EVIDENCE: The manager, Michelle Daglish, took up her post eleven weeks before the inspection and has applied for registration by the Commission. She is suitably qualified and has a lot of previous care home management experience. At the Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 24 time she started in her post, the home had been without a permanent manager for some months. At the same time, the home has been taken over by Southern Cross, which has meant a lot of change for people living and working in the home. A meeting had been held with residents and relatives to inform them of these changes. Since her appointment, Mrs Daglish has focussed on identifying staff training needs and arranging required training as well as implementing the new company’s policies and procedures. Good progress has been made in these areas. A member of staff who completed a survey said, ‘I believe the new manager is very supportive as she has been so with me’. The manager said that two of the residents regularly came to see her to give their views and opinions and she had had good feedback from some relatives of residents. She said she also spends time ‘on the floor’ speaking with residents. She had arranged an evening ‘manager’s surgery’ the previous week to encourage residents and relatives to share their views about the home, but no one turned up. Residents spoken to were aware of the management and company changes. Four said that they found the new manager was not very approachable and had a perception that she was very busy in the office and not easily available to residents. The comments of residents generally suggested that the new manager does not yet have as visible a profile with residents as the previous manager. There is a quality assurance system in place, with regular audits of systems in the home being carried out. Surveys of residents, relatives and other interested stakeholders have not yet been carried out but will be in future. The administrator handles personal allowances for some residents. Records were kept of monies held on behalf of residents, which showed the dates money was deposited or withdrawn/spent and what it was used for. Receipts/records were kept where item/services had been obtained on behalf of individual residents. The company carries out regular audits of the system. The manager said she is ensuring staff have supervision (one to one discussions) at two monthly intervals and a carer confirmed this. Three staff records were looked at which showed that staff received training in essential areas, which affect health and safety. More training is planned and being carried out. Up to date evidence of maintenance/safety checks on fire systems, the lift, gas system and moving and handling equipment, was in place. Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 25 Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 26 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 3 3 3 3 N/A 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 2 2 X X 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 3 X 3 3 X 3 Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Not applicable 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 The temperature of the medication storage area must be checked daily and a record kept. This is to make sure that the temperature is safe and will not cause medications to deteriorate, for example, if it is too hot. Timescale for action 30/06/08 2. OP21 23(2)(j) Where any resident wishes to look after their own medication, an individualised risk assessment must be carried out to assess whether there are any risks to the resident or anyone else, if they do this. Where any risk is identified, the assessment should clearly set out how these risks should be controlled or reduced, whilst promoting as far as possible, the resident’s right to look after their own medication. The resident or their representative must agree any actions. Broken baths and showers must 31/08/08 be repaired or replaced. There must be at least three communal assisted baths or shower facilities. En-suite showers, which are in disrepair, must be DS0000070972.V356915.R01.S.doc Version 5.2 Page 28 Riverside House repaired. 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. Refer to Standard OP8 Good Practice Recommendations Obtain training for care staff about the prevention of falls, which will help them to put plans of care into place that are more effective when residents are at risk of falls. Advice could be sought from the local Falls Prevention Service who may be able to help with this. Review the availability of suitable hoisting equipment in the home, to ensure that residents are not kept waiting for unreasonable periods of time when they need assistance with their personal care that can only be provided with the use of a suitable hoist. If problems are identified, obtain suitable equipment, to overcome this. Consult residents for their opinions about the seating arrangements in the main lounge area and try to accommodate these where possible, ensuring that residents’ health, safety and wellbeing is safeguarded. This should help residents to feel more ‘at home’ and more in control of their living environment. Look at other ways of enabling residents to get to know the new manager, which will help ensure that they feel able to tell her their opinions and concerns and promote an open, inclusive atmosphere in the home. 2. OP8 3. OP20 4. OP32 Riverside House DS0000070972.V356915.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 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 © 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 DS0000070972.V356915.R01.S.doc Version 5.2 Page 30 - 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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