Inspection on 20/10/05 for Riverside House Residential Care Home

This inspection was carried out on 20th 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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Riverside House Residential Care... 26/01/07

Riverside House Residential Care... 23/01/06

Riverside House Residential Care... 07/12/04

Riverside House Residential Care... 14/06/04

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

CARE HOME ADULTS 18-65 Riverside House Residential Care Home 337a Seven Sisters Road Hackney London N4 1QR Lead Inspector Kristen Judd Unannounced Inspection 20th October 2005 11:30 Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 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 Residential Care Home DS0000010284.V259318.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 Adults 18-65. 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 Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Riverside House Residential Care Home Address 337a Seven Sisters Road Hackney London N4 1QR 020 7503 5978 020 7503 5978 dymphnacaulheld@hotmail.com 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) Mr & Mrs Despo & Jim Gopalla Mrs Dymphna Caulfield Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th December 2004 Brief Description of the Service: Riverside House is a care home offering care and support to service users who have mental health support needs. The home offers support for service users preparing to live within the community, offering accommodation, supervision and assistance. The home operates a key worker system; service users receive guidance with regard to managing their personal care, health needs and finance. The home has adopted a multidisciplinary approach to working with service users, liaising regularly with external professionals. The home is a three-storied house on Seven Sisters Road, a main road, near Manor House Station in the London Borough of Hackney. The home is nicely furnished and decorated with a homely appearance. At the time of the inspection the home accommodated seven service users. Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced which started at 11.30 am. This inspection followed up the requirements made at the unannounced visit held on 7th December 2004.The inspector spoke with several service users and staff during the inspection. A tour of the environment was undertaken and samples of the homes records were examined. There have been 4 requirements made following this inspection. One of which management responded to at the time of inspection. Verbal feedback was given to management at the end of the inspection. The inspector wishes to thank the staff and service users for facilitating this unannounced inspection and actively contributing to the regulatory process. A feedback card was left for completion. What the service does well: What has improved since the last inspection? 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 Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3&4 The inspector believes that the home is able to meet service users needs in line with the homes Statement of Purpose. EVIDENCE: Service users are provided with a Statement of Purpose, which provides all the relevant information and clearly reflects the aims of the home and how those aims will be met. The residents’ guide has been developed; this document has been presented in a suitable format. The inspector viewed the one service user file who was in the process of trail visits to the home with a view to a permanent placement. The referral process is clear with a full needs assessments for being received for the prospective service user. The file evidenced well a completed full needs assessment by the referring agency (mental health specialist team) and a subsequent assessment is completed by the manager of the home. This was supported by an additional visit to the service user by one of the deputy managers. The referring authority also provided the current care plan and risk assessments that were in use during the trail visits. Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 8 Through discussion, the inspector was satisfied that the staff were able to demonstrate that the home has the capacity to meet the service users’ needs. Evidence was seen during the inspection that confirmed that there is a close liaison with health professionals with regard to accessing specialised services in relation to mental health issues. Staff observed during the inspection were able to communicate well with the service users and clearly had a good rapport. Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8&9 The inspector believes that service users needs are being met by a competent staff team who were seen to be promoting independence in line with the individual care plans. EVIDENCE: Evidence showed that individual plans were being evaluated on a regular basis involving a multi-disciplinary approach to care planning. The individual service users plans record the agreed objectives and expected outcomes. Service users sign in agreement to the care plan. Daily recordings indicated that staff closely liaise with health professionals when appropriate. Monthly summaries are completed by key workers, which provide an overview of the service users current situation. Through discussion with staff the inspector was informed that the process of assessing risk includes consultation with the service user, and other key professionals. Issues explored included the misuse of alcohol and drugs, the impact of mental health diagnosis, aggressive/violent behaviour and the carrying of a weapon. Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 10 Risk assessments seen on file were detailed and included actions to be taken to minimise identified risks. The inspector was satisfied that the files reviewed evidenced relevant and appropriate risk assessments to minimise risk without imposing inappropriate restrictions on the service users. Service users are very independent and there was evidence that service users are involved in the day-to-day running of the home, participation in activities of daily living and involvement in choice of daily activities. Daily living sheets records the daily living tasks to be undertaken tasks, appointments and any activities. Service users are given £20.00 per week to purchase their own shopping in addition to their own monies. Service users plan their own meals, some cook for each other on occasions. Service users house meetings are held weekly, are generally managed and minuted by service users themselves minutes reflected that numerous issues of interest/concern to service users are discussed. Day to day issues were discussed, and there was evidence of a discussion about Christmas and what service user would like to do to celebrate. Additionally service users have the opportunity to request renewables for the house. Additionally the inspector was informed that service users are invited to attend some parts of staff meetings to be kept informed of developments at the home and a forum to raise any issues from service users. Through observations made during the inspection the inspector was satisfied that service users are given every opportunity to make their own decisions on a daily basis. Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13&17 The inspector observed and was satisfied that staff provide service users with support to make choices and provide them the opportunity to lead independent lives. EVIDENCE: The ethos of the home is to promote all the service users to be independent and to maintain and develop their social and daily living skills. The inspector was informed that individual key work sessions offered opportunities for emotional support to be offered. Through interview with both the deputy managers and observation of records, the inspector was satisfied that service users’ are involved in the day to day running of the care home. The inspector spoke with several service users during the inspection. Service users stated that they had good opportunities to develop a range of skills. Service users are encouraged to complete all their own daily living tasks such as laundry, shopping and preparation of meals and management of their own finances. Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 12 The staff encourage service users to be involved in activities in the community, one service user for example was participating in gardening related work experience three times weekly. The inspector spoke with the service user who clearly enjoyed attending the project. Another service user accessed a local day centre twice weekly. One service user who was on trail visits had been enrolled on a Jazz music therapy course and had already started to attend. Staff were observed interacting with all of the service users throughout the inspection. The interaction was extremely positive and the good relationships between service users and staff. Service users were seen to move around the home without any restrictions. As previously stated service users are given money each week for shopping and are responsible for the planning and budgeting of their meals. Each service user has a locked food cupboard where dried foodstuff is stored; the communal fridge also is divided into compartments for use of individual service users. Periodically, service users share a meal out or a take away meal together. Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18&20 It was the inspectors’ view that medication was being accurately administered on a daily basis however staff must evidence this by accurate recording. EVIDENCE: Through observation during the inspection the inspector was satisfied that the service users are supported to maintain their personal identity and choice. Service users are very independent although some require encouragement/ prompting with regards to their personal care. Guidelines are in place around this in their care plans. On the day of inspection staff were observed to knock and wait for an answer before entering bedrooms, and all service users are offered keys to their individual rooms. There was information that showed that appropriate health checks are completed when needed. Service users were not restricted as to when they got up and staff were flexible regarding daily routines. Although service users are requested to return to the house by 11.00pm at night, if they are staying out they are keep staff informed. Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 14 The service users’ files show evidence of close liaison with health professionals with regards to continually assessing service users’ needs and accessing specialised services in relation to mental health issues. Files also evidenced medical appointments made and kept by service users and their outcomes. The inspector was satisfied that the staff are fully aware of service users’ needs and makes appropriate referrals when required. Service users files contained documented medical appointments for example GPs, chiropodist, dentist, and specialist clinics. Policies and procedures were available for guidance on the administration of medication. The procedure did not cover homely medications however this was forwarded to the Commission following the inspection. Service users medication is provided in doset boxes. The home appropriately stores medication in a locked medication cabinet. The inspector completed four spot checks on medication one of which was incorrect at the time of inspection. Medication records were correct. Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 15 Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The inspector is satisfied that staff are fully aware of Adult Protection issues and would respond appropriately. EVIDENCE: There is information about how to complain on display in the home. The inspector noted that the service users complaints format was in pictorial format, which was very user friendly. Records indicated that there have no complaints since the last inspection. The home has Adult Protection procedures in place. The inspector was informed that procedures for dealing with Adult Protection are highlighted within staff induction .The is further Adult Protection training, the format for the training was seen during the inspection and appeared comprehensive. The inspector was informed that there have been no allegations in regards to abuse within the home. Staff spoken to at the time of inspection had adequate knowledge of adult protection. Most of the service users are able to manage their own finances additionally some service users monies are held by staff on their behalf, and stored in a locked safe. Records and receipts are maintained of all financial transactions involving service users monies. The monies held in respect of petty cash and individual service users records were examined all of which were correct at the time of inspection. Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): It is the inspectors view that the environment is suitable for purpose and it is well maintained. EVIDENCE: The home is situated in a residential area of Stamford Hill and is within easy access of transport links and the local community. The home is within walking distance of some local amenities; there is a garden area and paking a a few cars on the driveway. A tour of the premises was conducted. The office is situated on the ground floor and is also used as the staff sleep in room. There is no separate visitors room available. At the time of this inspection there were seven service users placed two of whom were on trail visits, the home which adequate private and communal areas. All of the individual rooms seen had been personalised and were comfortable. All of the communal areas and service users bedrooms were of adequate cleanliness and hygiene, appropriately heated, lit and ventilated. The home has plenty of bathing facilities having four shower rooms and one bathroom. Additionally service users have sinks in their bedrooms. Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 18 Staff and service users share the cleaning within the care home. There is a separate laundry facility, which was clean and tidy. The home does not cater for service users with significant physical disabilities and therefore does not have or utilise disability equipment. Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,34,36 It is the inspectors view that the home has an experienced and effective staff team who work well together to provide an excellent level of care to service users. However staffing must be maintained at appropriate levels at all times as potentially this could put staff and service users at risk. EVIDENCE: The inspector was satisfied through discussions and observations made during the inspection that the deputy managers and staff are aware of their own roles and responsibilities and have developed good relationships with service users and are fully aware of service users needs. Rotas indicate that staffing levels are generally satisfactory. However it was noted that as there is a current vacancy for the permanent sleep in staff member this has resulted in one waking staff member being on duty after 8.30pm.The inspector acknowledges that the management responded to this concern immediately and the staffing was increased to one waking night and one sleep in on the night of inspection. Rotas seen at the time of inspection accurately reflected the staff on duty. There is an on call emergency procedure in place. Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 20 Through observation and discussions with staff they demonstrated a clear understanding of their roles and responsibilities, and a high level of knowledge around individual service users. Staff were observed to interacting with service users in a relaxed and respectful manner, and there was evidence that good relationships have been built up with service users. A sample of three staff files was seen all of which evidenced that the home had undertaken the necessary recruitment checks to ensure protection of residents. However it was noted that one reference, which had been provided as a professional reference, was not on headed paper and there was no information to evidence that the reference had been verified. Criminal Records Bureau checks were complete. Minutes for team meetings were seen which are held monthly. Minutes were seen for October 05. The content of the meeting was good; items that were discussed were as follows: Medication Sleeping in vacancy National Vocational Qualifications Minutes evidenced that in the second part of meeting a service user is invited to attend to be kept informed of any outcomes of the meeting. Service users are supported by key staff, which enables a good relationship to develop. The registered manager and both the deputies supervise staff. The registered manager is supervised directly by the responsible individual. Supervision records were seen with regard to three members of staff. Evidence was seen to show that supervision is in line with the National Minimum Standards of at least six times yearly. Staff had also completed appraisals, which were seen at the time of inspection. Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38,39,41&42 The inspector believes that the current management provides stability for staff, which in turn is providing a positive atmosphere within the home for service users. EVIDENCE: All the staff and service users were friendly, open and appeared comfortable within the care home. The home’s records are well kept, recording is clear and all records are formatted well. The individual service plans are good and contain relevant information. Records regarding accidents and incidents were seen. The monthlyunannounced monitoring visits have been untaken; reports, which are very comprehensive and clear, were available for inspection. Service users house meetings are being held weekly and copies of the minutes were available. Evidence showed relevant issues were discussed such as: Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 22 House issues Renewals Arrangements for Christmas. Evidence suggested that service users take an active role in the discussions and are listened to, as previously stated a service user is also invited to part of the staff team meeting. Service users finances and petty cash was checked and deemed correct at the time of inspection. The home holds staff meetings, service user meetings, care plan reviews and staff supervision, all of which contribute to the quality assurance in the home. Relevant documentation/certificates was seen regarding the health and safety however there was no evidence that the electrical check was valid .A current certificate must be forwarded to the Commission for Social Care Inspection. Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score 3 x 2 2 x 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score x 3 3 x 3 2 x Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 24 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA20 YA33 Regulation 13.2 18.1(a) Requirement The registered manager ensures that medication is administered and recorded accurately. The registered manager must ensure that appropriative staffing levels are maintained at all times The registered manager must ensure that professional references are checked for authenticity. The registered manager must ensure that a valid electrical certification is forwarded to the Commission. Timescale for action 15/12/05 30/11/05 3 YA34 19.4( c) 15/12/05 4 YA42 23.4 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Riverside House Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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 Residential Care Home DS0000010284.V259318.R01.S.doc Version 5.0 Page 26 - 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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