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Inspection on 21/11/08 for Riversway Nursing Home

Also see our care home review for Riversway Nursing Home for more information

This inspection was carried out on 21st November 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Riversway continues to provide information, for people who may wish to move into the home, in a format that they can access, being Braille or a translation of their documentation. A full assessment of their needs is carried out before a place is offered. People spoken to said they felt well cared for by skilled and well trained staff. Surveys carried out by the home included comments such as, `very pleased with the care provided,` `very friendly environment, staff and management very helpful,` `all staff make a good effort,` and `excellent care, excellent food.` These comments were confirmed by people in the home who said that staff were very caring and understood their individual needs as well as finding time for a chat. Care plans showed that staff were aware of the need to record personal preferences ensuring people received care the way they wished. A full and varied activities programme is offered and people living in the home are encouraged to have a say in the running of the home, therefore having an input into the type of activity they would prefer to take part in. People we spoke to said there was plenty to do if they wished to join in. Others said that they were enabled to remain in their room if they preferred. Staff training ensures people are looked after by staff that have the relevant skills to meet their needs. Training co-ordinators make sure that all staff are up to date with manadatory training and that training specific to individual needs is accessible. People live in a home that is purpose built and enables them to maintain their independence with the assistance of aids and adaptation provided by the home when required.

What has improved since the last inspection?

The manager and staff have worked hard to meet the requirements and recommendations from the last inspection. This has been supported by regular self assessments, audits and Quality Care Reviews, as well as the input from an independent consultant who has helped the staff to be more aware of the National Minimum Standards and their impact on peoples lives. This means that peoples care is supported by care plans that contain enough information for staff to follow including wound care plans and individual risk assessments for falls and pressure area care.

What the care home could do better:

On the first day of the inspection issues regarding the management of medication were identified, this was discussed with the manager who investigated the gaps in medication immediately, and revealed communication problems with the pharmacy supplier, which the manager stated would be addressed. As the issues were dealt with immediately a requirement was not made, however we did recommend that the manager ensured that when staff make handwritten entries on the medication charts they are signed, witnessed and written in full with no abbreviations.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Riversway Nursing Home Crews Hole Road St George Bristol BS5 8GG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Juanita Glass     Date: 2 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Riversway Nursing Home Crews Hole Road St George Bristol BS5 8GG 01179555758 01179540145 riversway@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Riversway Care Limited care home 69 Number of places (if applicable): Under 65 Over 65 69 0 old age, not falling within any other category physical disability Additional conditions: 0 6 The Registered Person may provide the following category of service only: Care Home with Nursing - Code N to service users 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) - Maximum of 69 places Physical Disability (PD) Maximum of 6 places The maximum number of service users who can be accommodated is 69 Date of last inspection Brief description of the care home Riversway is registered as a Care Home for a maximum of 69 people requiring nursing care including younger physically disabled people. The Home is situated in the residential area of St George, occupying a riverside site, with easy access to local community facilities and is less than 2 miles to Bristol city centre. It can be accessed by car, or by bus with a short walk. The Home is purpose built, providing mainly single en-suite bedrooms, with five shared rooms with en-suite facilities. The rooms are spaced over two floors and divided into 4 Care Homes for Older People Page 4 of 28 Brief description of the care home wings. Each floor offers bedrooms, a lounge and dining room as well as bathroom facilities with aids and adaptions for people with a disability. There are pleasant gardens to the front and side of the property, a conservatory and a balcony accessible from the upper floor. There is a passenger lift providing access to all communal areas. All parts of the home are accessible to wheelchair users. There is plenty of parking to the front of the property with ramped access up to the home and main reception area. The basic fees charged for staying at the Home range from 560 for a shared room to 585 a week for a single room. Fee levels are dependent upon assessed needs and therefore the full costs could be considerably higher than this. The home makes additional charges for a number of other services and these charges are listed in the service user guide. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection took place over two days and a total of 11 hours were spent in the home. To gather enough evidence to support our judgments for this inspection, We The Commission asked the service provider to complete an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people living in the home. It also gives us some numerical information about the service, and how they intend to maintain or improve outcomes for people using their service. We had not requested surveys on this occassion and reviewed comments made by Care Homes for Older People Page 6 of 28 people in the annual survey carried out by the home and the minutes of resident meetings. Once we had received the AQAA we carried out a visit to the home and spoke to people living there and staff. Whilst in the home we also looked at documents maintained for the day-to-day running of the service. These included care plans, staff recruitment, training and supervision. Also records relevant to the administration of medication, service records and health and safety. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 28 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents benefit from approriate written information that can be provided in an alternative format, a chance to visit the home and a full assessment of their needs. This means they can make an informed decision before moving into Riversway and their needs are fully met. Evidence: We, The Commission looked at a copy of the homes Statement of Purpose and Service user guide. This was readily available in the home and provided immediately. A copy was available in the entrance hall for anyone interested, the manager confirmed that the Statement of Purpose could be provided in Braille. We saw the contact details for translation services enabling the home to provide information in an alternative language. We saw that the information for prospective residents was well written and contained all the information a person would need to tell them about what care the home can and cannot provide. Care Homes for Older People Page 11 of 28 Evidence: The Statement of Purpose also states clearly the fees charged and what they pay for with a list of extra charges clearly mentioned. It also stated that the home can accommodate the different cultural and religious needs of people who may wish to move into the home. We saw in a residents room a copy of the Service User Guide which is written as a Welcome to the home it was very easy to read and provided ample information to help make the first days in the home easier. We spoke to the manager about how they would assess a person who wished to move into the home. She said they would visit the person either at their home or in hospital. They would talk to them, a relative or advocate and staff at the hospital or a social worker. They would also look at existing care plans for the person. We then looked at the records held in the home for people who had not lived there very long. They all had completed assessments and community or hospital care plans. We spoke to the people living in the home, but they did not mention how the experience of moving into Riversway had been for them. People wanting to move into Riversway can visit and spend some time to meet other people living there and staff who will be looking after them. This is often done by a relative or advocate on their behalf. If the manager and staff feel they can meet the needs of the person they will offer a trial period when both the person moving in and staff can decide whether the home is really the best placement for them. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home benefit from personal and specialist healthcare support that is provided in a person centred way respecting their privacy and dignity. They are enabled to make decisions about the way care is provided. They benefit from and are protected by the homes policies and procedures for the administration of medication. Evidence: We looked at the care plans for four people. Each plan was clearly written in a person centred way, this meant that people could receive the care they wanted in the way they prefered. Since the last inspection a lot of work by the manager and staff has been put into ensuring the care plans clearly reflect the assessed needs of the person as an individual. In the plans we looked at, we saw in depth risk assessments that were then confirmed with a plan of care that corresponded with the findings of the initial assessment. The care plans showed a specific emphasis on recognising the individual needs of a person rather than nursing tasks. For example there was clear guidance for care staff on how an individual prefered to be helped with personal hygiene, washing and dressing. All the care plans showed evidence of a monthly Care Homes for Older People Page 13 of 28 Evidence: review, any changes were then clearly identified for people to follow. We also saw that peoples needs are re-assessed annually by staff and their care plans re-written to reflect any changes that may have been perceived. Wound care plans had improved since the last inspection. They indicated clearly the current treatment plan in place, the progress being made and any input received from the tissue viability nurse if requested. We saw that specific risk assessments for the use of bed rails and lap belts now also contained a statement to support thier use. A falls risk assessment was only carried out following the use of an initial screening tool used by the PCT and social services. A full falls risk assessment was seen to have been completed and reviewed regularly when this screening tool identified the possible risk of falls. People spoken to said they were happy with the level of care they received. One person said the staff go out of their way to look after me, just as I like to be looked after. Another said they felt the care provided was excellent and they could not find any fault. One visitor said they were more than satisfied with the care their relative received and had seen a marked improvement since they had moved into Riversway. Another visitor said they felt completely satisfied that they could leave their relative and know that they were clean, comfortable, well fed and very well looked after. We looked at the records the home keeps for the ordering, storage and administration of medication, we also observed qualified staff giving medication to people during the visit. Qualified staff were observed to be following the correct procedures when administering medication making sure people were protected by their practices. On the first day of our visit we discussed with the manager some issues regarding out of stock medication. The manager agreed to look into why some peoples medication had run out meaning they had not been able to take what was prescribed. On the second day the manager confirmed that she had investigated the issue and had found that although qualified staff had contacted the pharmacy supplying the home on several occassions they had not delivered the medication required. The manager also confirmed that she was in the process of addressing these issues with the pharmacy concerned. We also discussed with the manager the need for staff to observe the practice of initialing handwritten entries on medication charts these also need to be witnessed by another person, this is to protect people from possible mistakes. We also mentioned the need for staff to make sure they write the prescription in full avoiding the use of abbreviations and Latin. Staff were observed to respect peoples privacy and dignity, people knocked on doors and waited before entering rooms and spoke respectfully to the residents in the home. Staff spoken to said they were aware of the importance of making sure that people in their care were treated with respect and that when they helped them they did it in a dignified manner ensuring they maintained privacy. They also said they were aware that it was important to keep up to date with individual needs rather than being task orientated. People spoken to felt they were looked after in a respectful dignified Care Homes for Older People Page 14 of 28 Evidence: manner. When we looked at the care plans they contained End of Life Decisions. These clearly showed how a person prefered to be looked after on reaching that stage in life. These were completed by people, with the help of staff or a family member if they wished, whilst they were still able to make an informed decision about the way they wished to be cared for. They included statements about whether they prefered to be nursed at Riversway or in hospital and statements about religious, cultural or personal rituals or practices that the person would like followed. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home benefit from the development of meaningful activities which recognises their diverse needs, likes and dislikes enabling them to maintain some control over their lifestyle. They benefit from continued contact with family, friends and the community. A well balanced menu means people benefit from a healthy and nutritional diet. Evidence: Riversway has a dedicated activities organiser who is responsible for arranging both one to one sessions and group activities. A social activity plan for the week was displayed in the hall and more than one person spoken to said that they knew there were activities going on and they could join in if they wished. One person said I prefer to keep to myself but there is always enough to do and the staff come in for a chat. One lady said she was pleased she could have her hair set regularly. People can join in entertainment provided by an outside entertainer, take part in music and exercise, discuss the latest news, watch a slide show or join the film club. One person said they particularly liked to go to film club and liked the large screen TV. Other activities provided included hat making, sale of Xmas gifts, quizzes, cream teas, arts and crafts sessions, karaoke and regular trips out into the local community. Special occassions Care Homes for Older People Page 16 of 28 Evidence: such as seasonal or cultural/religious festivities or birthdays are also celebrated. People spoken to said they were able to maintain contact with family and friends which was important to them. As the home has their own transport people are able to go out into the local community and maintain contact with local friends and peers. Riversway has its own Chapel Room and Mass is held regularly. Other denominations also hold services in the home and the Statement of Purpose states that visits can be arranged from religious leaders for other beliefs if requested. Resident meetings continue to be held and the minutes showed that people are encouraged to have a say in the running of the home. They have suggested trips, activities and changes to the menu which have been managed by the home. A copy of the weeks menu was available in the hall for people to look at. A 6-8 week menu is followed rotating on a weekly basis. The menus showed that there is a choice of wholesome nutritional meals and records kept showed that people often request a meal that is not on the menu enabling them to maintain choice if they do not like either option or if they have a cultural or personal preference for a different meal. People spoken to said they always had a good meal and one person said the meals were excellent with plenty of choice. When there is a Birthday the person is offered a Birthday Treats Menu which means they have the choice of what they eat from that menu through the day, the cook is aware of Birthdays and a cake is made for them to share with their family and peers. People are asked if they prefer to eat with the community or in private, one person said that they prefered to eat in their room in private and staff respected their decision and helped them to do so. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from and are protected by the complaints and safeguarding procedures in the home. Staff are fully aware through training of the procedures to follow to protect people from abuse. Evidence: Copies of the homes complaints policy and procedure are included with the Service User Guide and available on request. As with the Statement of Purpose this policy can be provided in Braille or translated for people whose first language is not English. People spoken to said they knew who to talk to, one person said they would get their daughter to handle anything like a complaint but felt that anything would be dealt with immediately, because thats what they are like here. When one resident indicated in the homes survey that they did not know how to make a complaint a new copy of the policy was provided and the procedure explained. The policy also informs people that they can forward their complaint to the funding authority and provides the address and contact details for CSCI. The manager maintains a record of all compliments and complaints received. One complaint had been received since the last inspection. There was a clear audit trail of the actions taken, the way the manager dealt with the complaint and the outcome. This evidence showed that the manager had dealt with the complaint appropriately. The home continues to develop good relationships with each person who lives there and their families right from the day they are admitted. This encourages them to raise Care Homes for Older People Page 18 of 28 Evidence: concerns before they become serious issues. The home has a Protection of Vulnerable Adults (POVA) policy. Staff spoken to were aware of the basic issues and said they would be more than willing to raise anything they considered bad practice with the manager, they indicated that they were aware of the homes whistleblowing policy and understood how they could use it. Training records showed that all staff are made aware of POVA issues in their induction and had also attended POVA training supported by regular refresher courses. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home benefit from a comfortable, well-equipped and homely environment, which is well maintained and decorated, with access to well maintained garden areas. People are protected by staff practices and awareness of appropriate infection control guidelines. Evidence: Riversway is a 69 bedded purpose built Nursing Home. Built in 1997 it was designed around the needs of people for whom it was intended. The home is set in its own landscaped gardens over looking the River Avon. People spoken to said they had lovely views of the river. All areas of the home are wheelchair accessible with a large passenger lift servicing the upper floor. People living in the home benefit from well decorated and furnished communal areas on both floors. Communal areas are further enhanced by a spacious conservatory on the ground floor and a balcony on the upper floor. If people prefer they can also sit in a quiet room or the Chapel which is also used by the film club. All the bedrooms in the home have ensuite facilities and additional aids and adaptations can be installed when needs indicate they are necessary. We did not look in every bedroom as they are peoples private areas, however the rooms we did see were well decorated and some people had personalised their rooms with their own furniture, pictures and family photographs. One person said they were pleased they Care Homes for Older People Page 20 of 28 Evidence: could bring their bits and pieces in with them as it made it feel more like home. All areas of the home were well maintained and decorated to a good standard. The company employs two maintenance staff to ensure the rolling programme of maintenance is met. The manager carries out a regular audit and any maintenance issues are reported via a defect sheet. The maintenance manager carries out a regular Health and Safety Audit. The home was clean and tidy throughout and no bad odours were noted. One person said the place is always so clean they work really hard to keep it looking nice. To combat any odours that may occur the home uses a revolutionary machine, which sanitises and deodourises a room using ozone. We observed staff using personal protective clothing appropriately and staff training records showed they had all attend Infection Control Training. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from and are protected by the staffing levels and skill mix of staff in the home. The homes recruitment procedures further protect them from the possibility of abuse. Staff training is of a high standard with a commitment to providing people in the home with staff skilled and trained to meet their specific needs. Evidence: We looked at the personnel files held by the home for some of their staff. We looked at the employment records for two recently employed members of staff. We also looked at the staffing rota and the training records for people working in the home. The staffing rota showed that there are always enough staff in the home with the right skill mix to support the different needs of the people living there. The Riversway Welcome Pack, explains for people how many staff would be on each shift and goes on to explain how they can identify individuals by their uniform. People spoken to said there were always enough staff in the home and they could always find some one if they needed help or someone to chat to. We noted that when the call bells were sounded there was very little delay in them being answered. Riversway has strict policies and procedures for the recruitment of new staff. The personnel files for two people who had recently been employed showed that the manager follows these guidelines as all the relevant checks such as references and a CRB (Criminal Bureau Records) check had been completed before the person started Care Homes for Older People Page 22 of 28 Evidence: work. This protects people living in the home from possible harm or abuse. Staff employment is also supported by an Equal Opportunities statement. Riversway employs one full time and two part time training co-ordinators, a senior training co-ordinator oversees the planning and provision of training for all staff in the home. When training needs are identified the co-ordinator will provide training inhouse or access appropriate training courses locally. All new staff work with a member of the training team as part of their induction ensuring they complete the necessary competencies. They then work with senior carers before being assessed as competent to work alone. We looked at the training logs kept for both care staff and qualified nurses these provided evidence to show that they had attended all mandatory training, as well as a range of courses relevant to their role and the specific needs of people in the home. A training matrix helps the training co-ordinator identify when people need to attend a refresher course. Since the last inspection Awareness of National Minimum Standards (NMS) has been introduced as training for all staff to enable them to ensure documentation in the home meets the NMS. Staff spoken to said that they felt very well suppotred when it came to training. One person said the fact that new people work alongside the training co-ordinators means you can ask for guidance and advice when needed not wait for a meeting. All staff spoken to said they were well supported in obtaining an NVQ qualification. At the time of our visit 40 of the care staff had obtained an NVQ 2 or higher in Health and Social Care whilst others were about to complete the course. Housekeeping and catering staff are also encouraged to do the relevant NVQ for their post. Riversway is accredited with the University of the West of England to offer placements for student nurses. This demonstrates the learning opportunities available at the home are good and encourage a learning environment. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a well run home with an appropriately qualified manager and supervised staff. They are protected from financial abuse through safe and stringent policies for managing residents money. Both people working and living in the home are protected by robust health and safety procedures. Evidence: The home manager Mrs Angela Glover has worked at Riversway since it opened in 1997, she has been the registered manager since 2001. Mrs Glover is responsible for the running of the home, she is a registered nurse and has achieved the NVQ Level 4 in Management. She is supported by the Deputy manager who has also attained the NVQ level 4. The home continues to monitor its performance well. Regular resident and relative meetings continue to be held and their views and opinions are welcomed about matters concerning the running of the home. We looked at the minutes kept for these meetings and spoke to people about how well involved they felt they were. Comments Care Homes for Older People Page 24 of 28 Evidence: varied as some people wished to be more involved than others but the general feeling was that management kept them involved and informed about the running of the home. As well as the regular regulation 26 visits when the operations manager talks to staff and people living in the home, an independent consultant has been enlisted to assist in auditing the level of care provided. This ensures that continued improvement in the provision of care is maintained. A monthly review of the quality of care is carried out, areas are identified and an action plan completed. This identifies action to be taken, by whom and a time scale, completion of which is reviewed the following month. This reflects good practice and is evident in the improvement in care plans and risk assessments used in the home. From this review ongoing training and discussion with staff about the National Minimum Standards has been developed. The manager has also joined the My Home my Life group to ensure that they can meet the needs of people who may not be able to express their wishes as well as others. Staff and resident surveys are carried out annually, these form the basis of a business and developement plan supported by the continued self assessment carried out by the manager and consultant. People who live in the home or their families are encouraged wherever possible to manage their own finances. For some people a local authority finance officer is appointed to manage their money. Where amounts of money are kept for safe keeping by the home, good administrative systems are in place to show all transactions to and from the account. A random audit showed that these procedures were being adhered to. There is a cascade arrangement for staff supervision in place with senior staff supervising a group of junior staff. The three training co-ordinators have been trained in staff supervision. Any issues arising are fed back to the manager and training needs are addressed. We looked at records that showed areas of good practice or training needs had been identified. The records had been seen and signed off by the manager. Staff spoken to said they received regular supervision where good practice was praised as well as suggestions made for training. We looked at records relating to the servicing of equipment used in the home. All the records were up to date and available for inspection, these included the COSHH records, which are the guidelines for staff to follow if they spill, drink or are splashed by chemicals used in the home. The implementation of Health and Safety within the home was satisfactory. All residents have personal risk assessments. Generic risk assessments were in place and reviewed regularly. A review of the firelog showed all tests, training and drills were being carried out to Fire Brigade guidelines. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 The manager needs to ensure that staff write presciptions in full avoiding abbreviations. When these hand written entries are made they need to be signed and witnessed. This is to protect people from the possibility of medication error. Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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