Inspection on 23/01/06 for Riverside House Residential Care Home

This inspection was carried out on 23rd January 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 no outstanding requirements from the previous inspection report, but made 2 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... 20/10/05

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 23 January 2006 11:55 rd Riverside House Residential Care Home DS0000010284.V278494.R01.S.doc Version 5.1 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.V278494.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 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.V278494.R01.S.doc Version 5.1 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.V278494.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th October 2005 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. Riverside House Residential Care Home DS0000010284.V278494.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced which started at 11.55am. This inspection followed up the requirements made at the unannounced visit held on 20th October 2005. The inspector spoke with service users, staff and management during the inspection. A tour of the environment was undertaken and samples of the homes records were examined. There have been two requirements made following this inspection. Verbal feedback was given 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. 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.V278494.R01.S.doc Version 5.1 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.V278494.R01.S.doc Version 5.1 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): 2&5 It is the inspectors’ view that the home is able to meet service users needs in line with the homes Statement of Purpose. EVIDENCE: The inspector reviewed the individual service user file for the service user most recently admitted to the home (January 06). The referral process is clear. The file evidenced well a comprehensive assessment process over a period of many months. Prior to admission records were maintained showing the day visits commencing in July 05, which progressed to overnight stays in August 05, this was increased to two nights through September and to three nightly periods in December 05 prior to admission. During these visits records are maintained of the service users progress. A monthly progress report was seen during the stays. Assessments carried out by the home are very comprehensive and continuous throughout the initial period. There is a personal history in each of the service users file. The Contract is the Statement of Expectations & Rules. Service user files evidenced the signed agreements. Additionally the service users are reminded about the house rules during their stay, evidence of this was seen in the minutes of the house meetings. Riverside House Residential Care Home DS0000010284.V278494.R01.S.doc Version 5.1 Page 8 Through discussion, the inspector continues to be 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.V278494.R01.S.doc Version 5.1 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): 6,7,9 &10 The inspector believes that staff are aware of service users support needs and that that service users are proactively involved in the care planning process. EVIDENCE: The most recent service user who was admitted to the home had a care plan this was viewed at the time of inspection. 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 continue to be completed by key workers, which provide an overview of the service users current situation. The inspector was informed that there were general health and safety risk assessments in place, for example staff supervision of service users use of sharp tools or kitchen knives, assessment of risk in relation to self-medication. Risk assessments seen on file were detailed and included actions to be taken to minimise identified risks. Riverside House Residential Care Home DS0000010284.V278494.R01.S.doc Version 5.1 Page 10 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. Each service user has a task list for the week, which indicates allocated slots for completing tasks such as room cleaning, shopping and laundry. Service user plans seen by the inspector showed evidence of service users being involved in decision making and service users views are recorded. Service users are able to go out freely in line with their individual service users plans. This was observed during the inspection. Service users where appropriately manage their own finances independently and records are appropriately kept of expenditure. House meetings are being held; these are minuted and were seen during the inspection the content reflected the service users being consulted in the dayto-day running of the home. There are policies in place with regard to confidentiality. The inspector observed that service users information was kept locked in the staff office. Riverside House Residential Care Home DS0000010284.V278494.R01.S.doc Version 5.1 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): 15,16 & 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 inspector was informed that service users’ family members were included in the planning of service users care as appropriate and in accordance to the service users’ indicated wishes. Some family members were keenly involved in service users’ care, whilst other play a minor role. The service users (and any known risk factors) determined the degree of family involvement. Evidence of family was seen on individual files. Oneservice users spoken to during the inspection stated that they had stayed at the home for Christmas dinner and then went home to be with their family. Service users who spoke with the inspector indicated that the home’s daily routines promoted independence and individual choice. Service users were seen to be making their own decisions about the structure of their day, what time to get up and what to have to eat. Riverside House Residential Care Home DS0000010284.V278494.R01.S.doc Version 5.1 Page 12 For example one service was to go out shopping with a staff member on the morning of the inspection however deicide to change this to the afternoon, staffing accommodated this request. The inspector was informed that all service users had their own keys to their bedrooms, food cupboards and the front door. Post is logged when received and service users sign when staff passes it on. There are clear rules and expectations with regard to smoking, alcohol and drugs. Service users are encouraged to develop daily living skills such as cooking for themselves in preparation of independent living. For those service users in need of support to develop food preparation/cooking skills, staff will supervise or provide support if needed. The inspector was informed that while meal choices are entirely the decision of service users, staff encouraged healthy eating options. Service users are given £20.00 per week to purchase their own shopping in addition to their own monies. Riverside House Residential Care Home DS0000010284.V278494.R01.S.doc Version 5.1 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): 19 &20 The home ensures that service users retain an appropriate level of independence regarding their personal and health care support, and has systems in place for when help is required. EVIDENCE: All service users are registered with GP’s upon admission and other health care services (dentist, opticians etc) are accessed as needed. The home has a very effective working relationship with a number of mental health specialists who provide focused input. The inspector felt, through speaking to both staff and service users that the staff treat service users with respect. The inspector was satisfied through indirect observation that the staff are very flexible with regards to the day-today running of the home. Staff were observed during the inspection encouraging service users to make decisions and complete tasks for themselves when appropriate. Service users were not restricted as to when they got up and staff were observed as being flexible regarding daily routines. Riverside House Residential Care Home DS0000010284.V278494.R01.S.doc Version 5.1 Page 14 Staff were observed interacting with all of the service users throughout the inspection. The interaction was extremely positive and there is clearly good relationships between staff and service users. Service users were seen to move around the home without any restrictions. The inspector was satisfied that staff were fully aware of service users medical needs and monitor compliance for service users who self medicate. The medication storage was in good order. Service users medication is provided in doset boxes and one in a blister pack, all which were seen and deemed correct. The home appropriately stores medication in a locked medication cabinet. The inspector completed checks on all generic package medication all of which were deemed correct at the time of inspection. Medication records seen were correct. Riverside House Residential Care Home DS0000010284.V278494.R01.S.doc Version 5.1 Page 15 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): 23 The home has good procedures in place to ensure service users protection and the staff spoken to appear clear about the procedure for adult protection. EVIDENCE: The home has Adult Protection procedures in place. Staff spoken to during the inspection had a good understanding of the policy and procedure for dealing with any concerns in relation to the protection of services users and was able to accurately describe the necessary steps. The inspector was informed that all staff have received Adult Protection training since the previous inspection. Most of the service users are able to manage their own finances additionally some service users have their money kept for them and it is stored in safe in the office. Records are kept of service users money, which includes signing monies in and out, with a running total. Staff members countersign when money is received and returned to and from service users. This provides a robust system to ensure that service users financial affairs are handled appropriately. Riverside House Residential Care Home DS0000010284.V278494.R01.S.doc Version 5.1 Page 16 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): 24,27&30 The inspector is satisfied that the home is suitable for it purpose and is maintained to a high standard of cleanliness. 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 of the communal areas 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. All of the communal areas 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. Staff and service users share the cleaning within the care home. There is a separate laundry facility, which was clean and tidy. Riverside House Residential Care Home DS0000010284.V278494.R01.S.doc Version 5.1 Page 17 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.V278494.R01.S.doc Version 5.1 Page 18 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): 32,33,34, 35&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 a robust recruitment process must evidence this. EVIDENCE: The inspector was satisfied through observation and discussions with staff they demonstrated a good understanding of their roles and responsibilities, and a high level of knowledge around individual service users needs. Staff members spoken to appear committed to the service users and the work that they carry out within the home. The inspector observed staff engaging with service users in a positive manner. Rotas indicate that staffing levels are satisfactory and there is sufficient staff on duty to meet the needs of the service users. There is a minimum of two members of staff on duty throughout the day and one waking night and one sleep in at night and an on call manager. This level of staff cover is sufficient to meet service user needs. The home has a core group of workers who have been employed at the home for a significant length of time. The management team facilitates much of the staff training available. Riverside House Residential Care Home DS0000010284.V278494.R01.S.doc Version 5.1 Page 19 The inspector chose two staff files at random. The first file had gaps in their employment history on their application form. Through further discussion with management it was clarified that the staff member was previously employed and had returned to work after travelling abroad however the old employment documentation was in use. This is deemed poor practise. The inspector raised concern with regard to the second file, as it did not contain any employment history. Additionally the employee had stated on the application form that they had a qualification basic in the NVQL2 and that they were undergoing the actual NVQL2, however supervision records indicated that this was not the case. Such irregularities should be explored with the applicant at the interview stage. There was evidence that Criminal Records Bureau checks had been undertaken. Supervision records were seen with regard to the two members of staff. It was noted that one had received supervision however there were no formal records maintained. The registered manager must ensure that records are maintained of all supervision sessions Staff has access to a range of training opportunities that are primarily facilitated by managers of the home. Recent training offered to staff had included Adult Protection, Challenging Behavior and Personality disorder. Additional training was booked in February for all staff for First aid and Basic Food Hygiene. Most staff members have also participated in external NVQ training. The inspector was informed that out of seven staff two have NVQL2, two have NVQL3 and two have NVQL4. Riverside House Residential Care Home DS0000010284.V278494.R01.S.doc Version 5.1 Page 20 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): 37,38,39 &42 The management teamwork effectively to maintain high standards of care, in line with the home’s stated aims and objectives. EVIDENCE: The inspector was satisfied that the home is managed in an open and positive way. 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 monthly-unannounced monitoring visits have been untaken; reports, which are very comprehensive and clear, were available for inspection. Residents of the home have good opportunities of explore openly issues of their care and support while living at Riverside House. Residents meetings are consistently convened, and residents are invited to participate in some parts of staff meetings to ensure they are kept informed of service developments. Riverside House Residential Care Home DS0000010284.V278494.R01.S.doc Version 5.1 Page 21 Service users who spoke with the inspector indicated that they were happy and satisfied with the service provision. The home holds staff meetings, service user meetings, care plan reviews all of which contribute to the quality assurance in the home. Relevant documentation was in place regarding the health and safety. Riverside House Residential Care Home DS0000010284.V278494.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 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 Standard No Score 1 x 2 3 3 x 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 3 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 2 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 x 3 3 3 x x 3 x Riverside House Residential Care Home DS0000010284.V278494.R01.S.doc Version 5.1 Page 23 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 Standard YA34 Regulation 19.1 Requirement The registered manager must ensure that all staff are recruited inline with regulation. The registered manager must ensure that all supervision sessions are recorded. Timescale for action 31/03/06 2 YA36 18.2 31/03/06 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 Residential Care Home DS0000010284.V278494.R01.S.doc Version 5.1 Page 24 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.V278494.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. 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