Inspection on 31/07/08 for Riverslie

This inspection was carried out on 31st July 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

Riverslie 23/03/10

Riverslie 18/08/09

Riverslie 28/08/07

Riverslie 15/03/07

Riverslie 19/05/06

Riverslie 09/11/05

Riverslie 06/07/05

Riverslie 02/02/05

Riverslie 13/10/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Clover House

Langrigg House

Parkside

Dystlegh Grange

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

CARE HOMES FOR OLDER PEOPLE Riverslie 79 Crosby Road South Waterloo Liverpool Merseyside L21 1EW Lead Inspector Mike Perry Key Unannounced Inspection 31st July 2008 10:00 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 Riverslie DS0000059055.V360456.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. Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Riverslie Address 79 Crosby Road South Waterloo Liverpool Merseyside L21 1EW 0151 928 3243 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) No email - one is being set up Innocare Limited Acting manager Colette Corfield. Type of registration No. of places registered (if applicable) Care Home 30 Category(ies) of Learning disability (1), Old age, not falling registration, with number within any other category (30) of places Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home with nursing - Code N, to people of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category Code OP; Learning disability - Code LD (Maximum number of places: 1). The maximum number of service users who may be accommodated is 30. 28th August 2007 Date of last inspection Brief Description of the Service: Riverslie is a Care Home with nursing and personal care only. In total the Home provides care for 30 service residents. There are 22 single rooms and four double rooms, some of these with ensuites. Bedrooms are situated on all floors. There is a single lounge located on the ground floor and a dining area that has two separate sittings for lunch and dinner also located on the ground floor. Riverslie is a converted building on three storeys and provides a small passenger lift to all floors. There are gardens to the rear of the Home that are accessible from the ground floor. All areas of the Home are accessible to the residents and there are handrails and ramps provided throughout Riverslie for this purpose. Riverslie is situated in the Bootle area near to the local parks and the docks. The surrounding area is mainly residential. The Home is set back from a dual carriageway. Parking is available to the front of the building and there are main travel routes that provide easy access to the Home. Mike Dempsey is the Responsible Person and the manager is Collette Corfield who is currently applying for registration with the Commission for Social Care Inspection. The manager has provided details for fees for the home which are from £322 to £487.90 per week. Riverslie DS0000059055.V360456.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 2 stars. This means the people who use this service experience good quality outcomes. The inspection was a ‘key’ inspection for the service and covered the core Standards the home is expected to achieve. The last key inspection was carried out in August 2007. The home was also visited in February 2008 to check on progress made following the key inspection. Prior to the inspection the manager was sent and completed a comprehensive form containing pre-inspection information (Annual Quality Assurance Assessment – AQAA) about the home, which assisted in directing the site visit. The inspection took place over a period of one day. We met with residents and spoke with relatives who were visiting the home. We also spoke with members of care staff and manager on a one to one basis. The responsible person for the Provider was also spoken with. A tour of the home was carried out and this covered all day areas of the home and some of the residents’ bedrooms (not all bedrooms were seen). Records were examined and these included residents’ care plans, staff files, staff training records, financial records and health and safety records. Some survey forms were sent to the home prior to the inspection so further residents, relatives and staff could make comments. At the time of this report five residents/relative surveys have been returned and ten staff surveys; and comments are included in the report. What the service does well: All residents and relatives felt that they had been given enough information so that they were able to make an informed choice about coming into the home. The written service user guide had been made available and these were also observed to be present in each room, in the information folder. All residents are assessed prior to admission to the home and the assessment process continues following admission. There has been a change to the documentation since the last inspection as the new manager, who has reassessed all residents, has updated it. Those assessments seen were very comprehensive and easy the follow so that all care needs were assessed. Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 6 All residents have care plans and these were found to be detailed and covered relevant aspects of the care. There was good personalisation with useful comments recorded to assist staff in their interactions with residents. One resident has particularly diverse care needs around behavioral issues and communication. This resident has been assessed carefully with input from social and health care professionals. There was a clear understanding of the resident’s social care needs and how this was important to maintain, including family contact, and the need for activity outside the home. The resident was spoken with and felt that the suport received was ‘exellent’ and that staff were very good in general: ‘It’s very flexible here – they try and accommodate what I want’. Relatives and residents were pleased with how staff approached the personal care of residents. Residents were observed to be clean and appropriately dressed. One relative commented: ‘the standard is very good. Mum has a call bell and they are very quick’. The residents and their relatives gave good feedback about all staff and the manager. Comments included: ‘Staff are very friendly. I know who to complain to but never have had to. We have regular meetings with the manager and staff’; ‘The staff are excellent and very caring’; ‘There’s always plenty of staff around’. Staff were observed to be warm and respectful with the residents throughout the course of the inspection. Staff were present in the lounge throughout the inspection and were readily available to meet the needs of the residents. There are in-house quality systems in place, such as regular audits for care planning, medicines and environmental checks so that quality can be monitored and improved on. This is important as together these form sound monitoring and feedback mechanisms that means the service can continue to develop positively. What has improved since the last inspection? Over the last two inspections (key inspection in August 2007 and random visit in February 2008) the home has developed and made progress in a number of areas. Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 7 More recently, the manager has reassessed all residents to ensure that the home is continuing to meet the care needs and any that have been assessed as needing more specialist or differing care have been placed appropriately with the help of social workers and health professionals. The kitchen staff have undergone training in both general kitchen management and also specific menu planning and meal requirements. The menus have been updated and the home has an ongoing record of any specialist diets. Staffing is now more settled, in that, there are both adequate numbers of care and ancillary staff on duty. The training of the staff has improved and this was commented on by all staff surveyed and spoken with, as well as evidenced in the training records. The staff team consists of 14 care staff and of these, nine now have qualifications at NVQ level so that the home can evidence a core of staff who are competent to carry out care. This is very good progress over the short time frame the manager has been in post. The manager has held ongoing resident and relative meetings in order to include their views as to the running of the home and to help in making residents feel that they can contribute to the daily life in the home. There have been some activities organised and a specified staff member has been assisting to organise a more structured day for residents. One relative’s comments (survey return): ‘There has been a vast improvement since the new manager Collette took over. Games, bingo, darts, etc. Also entertainment officer has been appointed. The meals have improved vastly. There is now home made soups, cakes and a variety of fresh fruit that the residents like’. A recommendation for staff to receive specific training and awareness around the reporting of allegations of mistreatment and abuse has been actioned. All staff have received training from Sefton Social Services Safeguarding Coordinator. There have been improvements to the overall environment of the home, including the level of cleanliness (more cleaning staff hours) and the provision of locked facilities in residents’ rooms so that property, etc., can be stored. What they could do better: The level of input into the care planning by residents and relatives could be made more evident. Relatives and residents generally spoken with had not seen care plans and the manager confirmed that this is something that needs further development. Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 8 Currently, there is no assessment tool for use if residents were to selfmedicate to any degree. This was discussed with reference to an example document. The wishes and ability to self-medicate need to be included on all admission and pre-admission assessments so that independence can be encouraged. One resident was observed to be prescribed a cream for application on a PRN (give when necessary basis). There was no statement in the medication record or the care plan to state why the medicine was needed. This is important to record so that all staff are applying the cream for the same purpose. During the inspection we discussed with the manager some observation made about the general environment of the home and these are listed below to further inform the process of continuous improvement and are listed as recommendations at the end of the report. One staff member discussed the induction programme for the home and the content seen seems to be relevant. Advice was given the manager to audit the current programme against the ‘skills for care’ standards to ensure that the programme fully meets requirements. The records for some residents’ monies were seen and it was observed that two signatures are not always witnessing individual transactions. The manager is also not in the habit of issuing receipts for money handed in for safe keeping. It is good practice to ensure these measures are taken and residents are fully confident. The maintenance person schedules routine safety checks in the home but does not include routine checks of windows above ground floor in terms of limited opening. This would be recommended to ensure safe compliance is monitored. 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. The summary of this inspection report can be made available in other formats on request. Riverslie DS0000059055.V360456.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 Riverslie DS0000059055.V360456.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): Standards 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents have a thorough assessment prior to being admitted and following admission to the home so that all care needs can be better addressed. EVIDENCE: All residents and relatives felt that they had been given enough information, both in writing and verbally, so that they were able to make an informed choice about coming into the home. The written service user guide had been made available and these were also observed to be present in each room in the information folder. The home’s statement of purpose and ‘service user guide’ have also been updated recently to include the name of the relatively new manager. This shows that the information available is always current. (It was pointed out that the contract address of the Commission for Social Care inspection (CSCI) needs updating). Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 11 All residents are assessed prior to admission to the home and the assessment process continues following admission. There has been a change to the documentation since the last inspection, as the new manager, who has reassessed all residents, has updated it. Those assessments seen were very comprehensive and easy the follow so that all care needs were assessed. They cover all areas of daily living activities, such as communication, lifestyle, sexuality, safe environment, mobility, mental state, dependency score, breathing, eating and drinking, eliminating, personal care, and the resident’s social history. Relatives felt that they had been consulted as part of the assessment process. Riverslie DS0000059055.V360456.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): All key standards Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home manages the health and personal care needs of residents well, so that residents are treated with respect and their dignity maintained. EVIDENCE: All residents have care plans and these were found to be detailed and covered relevant aspects of the care. There was good personalisation with useful comments recorded to assist staff in their interactions with residents. One resident has particularly diverse care needs around behavioral issues and communication. This resident has been assessed carefully with input from social and health care professionals and has also been followed up routinely with relevant psychiatric review. There was a clear understanding of the reident’s social care needs and how this was important to maintain, including family contact, and the need for activity outside the home. As part of the review process the resident also receives external community support from a visiting care worker. Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 13 The resident was spoken with and felt that the suport received was ‘exellent’ and that staff were very good in general: ‘It’s very flexible here – they try and accommodate what I want’. The care plans are evaluated on a regular basis with all care needs commented on in terms of any progress made. All the care plans are subject to regular auditing by the managers. The level of input into the care planning by residents and relatives could be made more evident. The resident discussed had signed risk assessment documents, which is good practice and evidences the sort of collaboration necessary. Relatives and residents generally spoken with had not seen care plans however and the manager confirmed that this is something that needs further development. All relatives and residents spoken with confirmed that they are kept informed about the care and that any medical or care appointments or reviews are fully reported. There are clear records of health professionals visiting. Similarly, relatives and residents were pleased with how staff approached the personal care of residents. Residents were observed to be clean and appropriately dressed. One relative commented that his mother always well dressed and that although spends a lot of time in her bedroom ‘‘the standard is very good. Mum has a call bell and they are very quick’. Medication was reviewed. Those administration records reviewed were clear and easy to follow evidencing those medicines had been given as prescribed. There are regular audits carried out by the manager. There are no residents who are self-medicating. This was discussed with reference to the home’s policies and procedures and good practice. Currently, there is no assessment tool for use if residents were to self-medicate to any degree. This was discussed with reference to an example document. The wishes and ability to self-medicate need to be included on all admission and pre-admission assessments so that any independence can be supported. One resident was observed to be prescribed a cream for application on a PRN (give when necessary basis). The medication record stated ‘give when required’. The nurse spoken with said this was for pain relief but there was no statement in the medication record or the care plan to support this. This is important to record so that all staff are applying the cream for the same purpose. Residents spoken with said that they receive their medicines on time. Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 14 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): All key standards Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The daily life and social care for residents continue to be developed so that residents generally are supported to feel relaxed and ‘at home’. EVIDENCE: Following requirements on previous inspection reports, the home has made good progress over introducing a more structured approach to the social life of residents in the home. The AQAA completed by the manager states: ‘We have an activities programme now and an activities organiser who helps plan. One resident we encouraged to maintain skills and has domestic chores in the home such as helping clearing tables. Key worker activity is recorded and individual files with activities is also recorded. The meals in the home have been improved with more choice available’. Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 15 At the time of the inspection we found the home to be very warm and welcoming. Residents were happy to chat and to tell about life in the home. All felt that things had vastly improved since the new manager had started with more activity provided and encouraged. One relative comments (survey return): ‘There has been a vast improvement since the new manager Collette took over. Games, bingo, darts, etc. Also, entertainment officer has been appointed. The meals have improved vastly. There is now home made soups, cakes and a variety of fresh fruit that the residents like’. Staff explained that residents have bingo, quizzes and occasionally an entertainer and a movie. Also there are local trips out to do shopping and to the park. The home does not have its own transport so further regular trips are not really possible. The garden is a good source of activity and one resident was observed pottering about, as it is accessible from the rear of the home. The activity record file has notes on afternoon teas and other garden activities. (A tour of the area observed that the garden shed was open with tools and paint, etc., exposed. The garden was also not safely enclosed at this point – see environment). The manager plans to develop things further and to include relatives on more occasions. Meal times have been reviewed and the menu updated. Residents surveyed and spoken with all commented on the improvement. The dining room was observed to be pleasant with tables laid and menus displayed. Residents have a choice of where they have meals. The dining room is not big enough for all residents (previous report findings) but currently not all visit the dining room. The day room is large enough to accommodate extra dining tables if needed. The recommendation has been left at the end of the report for further consideration of dining room space. The kitchen staff have all received additional training around kitchen management and special diets as recommended previously. Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 16 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): Key standards Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. There is a good complaints process and the home has responded appropriately to concerns raised so that residents are protected. EVIDENCE: The complaints policy for the home is in the home’s information guide (service user guide) and copies of this are in each room. The manager was able to show evidence that complaints are taken seriously by the documenting and monitoring systems in the home. There is a ‘complaints book’, which listed six in-house complaints, and these had been documented and dealt with appropriately. We received one complaint during the inspection concerning the laundry but the manager was already aware of this and was in the process of responding. The manager was able to discuss an allegation of abuse that had occurred in the past and how this had been dealt with. She has responded to requirements made previously for more staff training in this area and the local safeguarding co-ordinator for Social Services has been to the home to complete some in-house instruction and training. Staff spoken with were clear regarding reporting of any incidents. Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 17 Residents spoken with enjoy the security the home offers and felt safe. They felt able to approach staff and felt supported. Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 18 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): Key standards. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. There are systems in place to ensure continued monitoring of the home’s environment so that standards can continue to improve and residents can be assured of a clean and comfortable home to live in. EVIDENCE: The AQAA returned by the manager lists further improvements to the general environment of the home over the past year. These include the introduction of more en-suite rooms, new flooring in some areas, reorganisation of the kitchen for easier maintenance, new kitchen and dining equipment, upgrading of the bathrooms and the fencing of part of the garden (following previous requirements). There has also been a review of the cleaning hours in the home, which are now fully covered on all days. Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 19 At the time of the inspection we found the home to be warm and welcoming. Residents were clearly settled and found the surroundings comfortable. The improvements were commented on by some of those spoken with. All areas seen were clean and generally well maintained. The AQAA also lists further scheduled improvements over the next year to further develop the home. This evidences both listening to residents’ views (some plans the results of surveying residents) and having systems in place to both monitor and improve quality. During the inspection we discussed with the manager some observations made and these are listed below to further inform the process of continuous improvement and are listed as recommendations at the end of the report. • The tool shed in the garden was observed to be left open with various tools and paint and other products easily accessible. This may present as hazardous for some residents. The side of the building accessible from this point was identified as having further hazards. The management may wish to section this area off which would provide additional security without compromising the garden area. The home has some bedrooms registered for two people. Currently, only one is being used as a shared facility (manager displayed good understanding of the standards to be applied in this area). The room has a moveable screen to assist with privacy for residents. This is both heavy and cumbersome and cannot be manipulated by residents – only staff. It would be recommended that a curtain system be installed which would be accessible and easily usable for elderly residents. This would increase independence as well as assuring privacy when needed. One bedroom on the ground floor was found to have a number of wheelchairs stored in it. This compromises the right of the occupant to have this free space and there is therefore a need to find independent storage space for wheelchairs. The laundry was found to be generally well managed. The flooring in one area was observed to be flaking and in need of a recoat of paint to ensure easy cleaning. The AQAA notes that there is an intention to further review the dining arrangements. The recommendation made previously has therefore been left in this report. We received one complaint on the day about the quality of the pillows and bedding in one room and this was fed back to the manager. • • • • • Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 20 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): All key standards. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff are recruited and trained appropriately so that residents’ needs can be met. EVIDENCE: At the time of the inspection there were 19 residents at the home and three carers and a trained nurse were supporting them. The manager also woks supernumerary to these figures and is in the home on a 9 to 5 basis. There is now a full complement of ancillary staff employed, including kitchen staff 8 to 6 pm and full domestic cover daily. A laundry staff is also employed. There are 30 hours’ maintenance cover. The staff team consists of 14 care staff and, of these, nine now have qualifications at NVQ level so that the home can evidence a core of staff who are competent to carry out care. This is very good progress over the short timeframe the manager has been in post. Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 21 The manager provided further information on staff training. This shows that the training opportunities and training needs of the staff team have been identified. The manager reported that the staff training programme is developing and records seen showed a progressive ongoing programme and staff interviewed had attended relevant courses. One staff member discussed the induction programme for the home and the content seen seems to be relevant. Advice was given the manager to audit the current programme against the ‘skills for care’ standards to ensure that the programme fully meets requirements. The residents and their relatives gave good feedback about all staff and the manager. Comments included: ‘Staff are very friendly. I know who to complain to but never have had to. We have regular meetings with the manager and staff’; ‘The staff are excellent and very caring’; ‘There’s always plenty of staff around’. Staff were observed to be warm and respectful with the residents throughout the course of the inspection. Staff were present in the lounge throughout the inspection and were readily available to meet the needs of the residents. Staff files were checked for new members of staff in order to assess the staff recruitment and selection procedures at the home. The files showed that preemployment checks are being carried out and staff records had the required police and written reference in place so that residents are protected by the home employing suitable staff. A photograph of the staff member is required and was missing, which was pointed out to the manager. Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 22 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): Key standards. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. There are good management systems in place to ensure that the home continues to develop in the best interests of the residents. EVIDENCE: Colette Corfield is the manager of Riverslie care home and has been in post since December 2007. She is qualified nurse (RGN) and also has completed the Registered Manager’s Award which is an NVQ qualification at level 4. Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 23 Colette has made many obvious improvements to the home and is keen to develop the service further. She displayed an open and positive attitude to the inspection process. She is not yet registered with CSCI (the regulatory body) and is in the process of applying for this. There are in-house quality systems in place, such as regular audits for care planning, medicines and environmental checks, so that quality can be monitored and improved on. The owner completed regular visits and audits (Regulation 26 audits) and these were seen. There is also an external quality audit conducted yearly (the RDB award). This is important as together these form sound monitoring and feedback mechanisms that means the service can continue to develop positively. The manager also holds regular meetings to conduct surveys to get the views of both residents and relatives. The management of the residents’ personal monies was reviewed. There is an accounting and auditing process. Monies are kept secure. The records for some residents were seen and it was observed that two signatures are not always witnessing individual transactions. This was particularly so when relatives were handing in money on a resident’s behalf. The manager is also not in the habit of issuing receipts at these times. It is good practice to ensure these measures are taken. The manager stated that each month a copy of the account is sent to the resident or relative. This is also in the home’s policy and is good practice. Health and safety is monitored in the home and the manager was able to explain the auditing system and the checks that are made. The maintenance person schedules routine safety checks but does not include routine checks of windows above ground floor in terms of limited opening. This would be recommended to ensure safe compliance is monitored. Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP1 OP7 Good Practice Recommendations The service user guide needs to be updated with the new contact address and number for CSCI. The level of input into the care planning by residents and relatives could be made more evident. This is recommended to help ensure that there is full collaboration. Currently there is no assessment tool for use if residents were to self-medicate to any degree. The wishes and ability to self-medicate need to be included on all admission and pre-admission assessments. There should be clear records on the MAR and care resident’s care plan for the indications for any PRN (give when required) medication. This is important to record so that all staff are applying the cream for the same purpose. 3 OP9 Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 4 5 6 7 8 9 Refer to Standard OP12 OP19 OP29 OP30 OP31 OP35 Good Practice Recommendations The use of space within the home should be reviewed to ensure that sufficient dining facilities are available. The comments made in the report concerning the development of the home’s environment should be included in the development plans over the coming period. A photograph of each staff member should be included in the staff file. Advice was given the manager to audit the current induction programme against the ‘skills for care’ standards to ensure that the programme fully meets requirements. The manager should continue her application for registration with CSCI. The financial records for some residents were seen and it was observed that two signatures are not always witnessing individual transactions. The manager is also not in the habit of issuing receipts when money is deposited for safekeeping. It is good practice to ensure these measures are taken. The maintenance person schedules routine safety checks but does not include routine checks of windows above ground floor in terms of limited opening. This would be recommended to ensure safe compliance is monitored. 10 OP38 Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Merseyside Area Office Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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 Riverslie DS0000059055.V360456.R01.S.doc Version 5.2 Page 28 - 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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