Inspection on 07/12/05 for Riversway Nursing Home

This inspection was carried out on 7th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Riversway Nursing Home 21/11/08

Riversway Nursing Home 20/11/07

Riversway Nursing Home 12/02/07

Riversway Nursing Home 08/12/04

Riversway Nursing Home 04/05/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Riversway Nursing Home Crews Hole Road St George Bristol BS5 8GG Lead Inspector Melanie Edwards Unannounced Inspection 7th December 2005 09:30 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 Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Riversway Nursing Home Address Crews Hole Road St George Bristol BS5 8GG 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) 0117 9555758 0117 9540145 riversway@btconnect.com Riversway Care Limited Mrs Angela Glover Care Home 68 Category(ies) of Old age, not falling within any other category registration, with number (68), Physical disability (6) of places Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. May accommodate up to 6 people with physical disability aged between 40 years and 65 years requiring perosnal and/or nursing care. Manager must be a RN on parts 1 or 12 of the NMC register May accommodate up to 68 people aged 65 years and over requiring personal and/or nursing care. Staffing Notice dated 12th June 1998 and CSCI notice of proposal letter effective 7th October 2004 re revised staffing levels apply. 14th December 2005 Date of last inspection Brief Description of the Service: Riversway is registered as a Care Home for a maximum of 68 residents requiring nursing care including young physically disabled residents. The Home is situated in a 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, by bus with a short walk. The Home is purpose built, providing a mix of double and single en-suite rooms. Care is offered over two floors and divided into 4 wings. Each wing offers bedrooms, lounge-dining room and bathroom facilities. There are also 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 resident areas. All parts of the home are accessible to wheelchair users. Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Twenty-six residents and several visitors were consulted to find out their views of the Home and the service provided. The registered manager, the responsible individual, Mrs Mary Rackham, manager, one registered nurse, three care assistants, and the chef were also consulted about their roles and responsibilities, training needs, and how they assist and support residents. Staff were observed assisting residents with their needs. A selection of records relating to the day-to-day running and management of the Home were inspected. A range of resident’s care records and care plans were also reviewed. The majority of the environment was seen with the only areas not viewed being a small number of resident’s bedrooms. Melanie Edwards and Glenda Simons carried out the inspection. 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. Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 6 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 Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4 Residents’ needs are assessed and well met, and residents and representatives are provided with the necessary information to make an informed choice about the Home. EVIDENCE: Copies of the statement of purpose and service users guide were inspected to see what information is provided to residents and their representatives. Both documents contained a range of detailed, helpful information about life in the Home, the staffing structures and levels, and the service that is provided, including information about daily life, as well as how they will be supported to meet spiritual needs while living at the Home. Copies of the previous two inspection reports were also included, which makes residents and representatives easily able to access Commission for Social Care Inspection reports. Copies of both of the documents are kept readily available on a coffee table in the entrance hall. To find out how residents needs are being assessed seven assessment records were inspected. Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 8 There was detailed information recorded about residents care needs. The assessments had been regularly reviewed and updated helping to demonstrate that staff monitor residents changing needs. There were moving and handling assessments completed for each resident to assist staff in safe working practices. There was an assessment for each resident around their vulnerability to pressure sores, risk from falls, and their nutritional needs .The completion of such assessments help demonstrate residents range of needs have been identified and addressed. All of the residents who were asked expressed positive views of the care they receive and how they feel their needs are met. Examples of comments made by residents included, `it’s one of the better homes,’ it’s very good we say what we like and it gets done’, they couldn’t be a better staff ’, and, `they put themselves out they are cheerful when I need something they are ready to do it’. Several residents said they felt there were occasions when they had to wait too long for their call bell to be answered, when they need assistance. However some residents also said they had spoken to Mrs Glover about this and she said she would address the concerns. Also the Home has a call bell monitoring system that means the time taken for any call bell to be answered is recorded. This can be used to help ensure call bell times are monitored. Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 Care plans and assessments demonstrate residents’ physical and psychological needs are met, and the practices and procedures for handling, storage and administration of medication are safe. EVIDENCE: Seven care plans were reviewed, to find out how residents are supported by staff to meet their care needs. The care plans were informative and detailed how to meet the health care needs of the person. Care plans were written in a simple and easy to follow style and included clear guidance for staff to follow to support residents with physical, psychological, social and spiritual needs. Care plans also addressed the psychological needs of residents, and detailed how to respond to the person if distressed or low in mood. The medication procedures and practices operating in the Home were also inspected, and demonstrated the Home operates a safe system of administration, disposal and storage of resident’s medication. Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,15 Residents are offered a varied nutritious diet and a range of social and therapeutic activities that are suitable for their needs. EVIDENCE: A full time activities co-ordinator works five days a week, and a member of the administration staff acts in an activities co-ordinator role specifically to engage residents who are cared for in bed, and residents with limited communication, in one to one activities. Several residents said how much they liked the activities organiser as one resident described her `she is marvellous ’. A copy of the weekly timetable of social activities is circulated to residents throughout the Home to ensure they are aware of current activities taking place in and out of the Home. Residents can take part in a range of social activities as well as exercise classes and regular trips out into the local community. A hairdresser service is also provided during the week, and a number of residents were observed having their hair attended to. The Home is clearly committed to providing a range of activities for all residents. Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 11 There are two dining rooms, one on each floor dining tables are covered with linen tablecloths and there are flower settings at each table. To inspect the quality of food provided a portion of both lunchtime meal choices were tasted. These consisted of either ham and leeks in a cheese sauce with mashed potatoes, roast potatoes and fresh cooked vegetables, or chicken supreme in a puff pastry base. There was a choice of homemade rice pudding, fresh fruit, ice cream, or yoghurts for dessert. The meals were tasty and well presented. The Home operates a rotating menu, and menu choices were well balanced and varied. All of the residents who were consulted commented positively about the quality of meals that are offered. Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 There are systems in place to help protect residents from abuse and to ensure complaints are responded to promptly and thoroughly. EVIDENCE: A copy of the complaints procedure, which includes the name of the Commission for Social Care Inspection for anyone who wishes to contact the Commission directly, is on display in the reception area. The contact details of the registered provider of the Home are included in the service users guide, if residents or representatives wish to contact them to complain. The record of complaints received was also looked at to see how the Home responds when complaints are made. There had been one written complaint received since the last inspection relating to care practices. There was information to show Mrs Glover had responded promptly to address the complaint. Many residents also said that they felt able to speak to Mrs Glover if they had any concerns. Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 13 There is a procedure in place relating to the issue of protection of vulnerable adults from abuse, which follows the Department of Health `no secrets’ guidance document when responding to allegations of abuse. The Home also has a `whistle blowing policy’ for staff to be supported, and to feel confident to raise allegations of poor practise in the Home .All staff are given a copy of the policy, to ensure they know their rights, and are `protected’ if they do raise legitimate concerns. All staff attend regular training sessions to help them in understanding the principle of the protection of vulnerable adults from abuse. Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23 24, 25 The Home is safe and well maintained and suitable for residents needs. EVIDENCE: The Home is located close to private houses, a short distance from local shops and nearby bus stops, making the Home part of the local community. The building is wheelchair accessible; and there is a passenger lift servicing the upper floor. The Home is a purpose built nursing home, designed around the needs of residents for whom it is intended. There are adaptations in place throughout the Home to assist residents who may be disabled. The majority of the building was viewed both inside and out. The only areas that were not seen were a small number of bedrooms. A full time maintenance worker is employed to address general maintenance and they were observed carrying out their duties during the inspection. Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 15 The environment is maintained to a high standard, and the standard of the fixtures and fittings are also very high. Residents were observed sitting in all of the communal areas, and in bedrooms. All Residents looked relaxed and comfortable in their surroundings. There is a spacious sized room on the first floor that is used for regular religious services and can be also used by residents for quiet contemplation. Each bedroom includes a television, as well as a telephone line that is provided by the Home. The service records were seen for the fire fighting equipment and for the lift. The records showed that external contractors had serviced equipment in the last twelve months. This helps demonstrate the Home is safe and well maintained. Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,30 Staff are competent and are well trained to meet residents needs. EVIDENCE: Three care assistants discussed with the inspectors what their roles and responsibilities were, and how they assist and support residents to meet their needs. In discussion with the staff it was evident they have a good understanding and awareness of residents range of needs. Staff also spoke very positively about the commendable range of training and development opportunities that they are able to take part in .One care assistant said they were in the middle of a `dementia awareness’ training course which they were finding very useful in their work. Staff were observed assisting residents with their needs in a sensitive and respectful manner. The staff on duty also said that they had attended a range of recent training in subjects relevant to the needs of residents. The Home is evidently committed to supporting staff to attend regular training to increase their knowledge and understanding of the needs of the residents in their care. It was reported that the Home adopts piously the ‘training up’ of members of the staff team. Two senior care staff who have received extra training, undertake training responsibilities with the staff team for a set number of supernumerary hours each week. This should provide further training and development opportunities for staff. Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 17 All of the residents who were consulted were positive in their views of the staff. Examples of comments made included, `they’re very polite courteous and friendly, ` I find them very good ’ and, `most of them are kind’. Several residents said that one or two staff are noticeably less helpful then the other members of the team. However the residents who made these comments said that this was not a specific problem. The residents concerned also said they felt very able to speak to Mrs Glover on this, and any other matters. Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The Home is well run with resident’s views actively taken into account by management, and there are systems in place to help protect the health and safety of residents, staff and visitors. EVIDENCE: Residents who were consulted spoke extremely positively about the registered manager and Mrs Rackham. Comments made by residents included Mrs Glover is ‘very good’, `very just and fair and treats everyone the same, and ‘she’s a very good matron’. Residents also said that Mrs Glover and other staff regularly ask them their views, and what activities and trips they wish to take part in. Residents also said they would happily speak to Mrs Glover or Mrs Rackham at anytime. A number of residents also said that Mrs Glover made her presence known in the Home every day she was on duty, and she regularly walks the floor’. This helps demonstrates Mrs Glover is keen to keep in daily touch with residents and staff. Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 19 There are regular residents meetings held and all residents are invited and senior managers also attend. Residents are encouraged to set their own agenda and discuss what they feel matters in the day-to-day running of the Home. Residents are also given their own copy of the minutes of the meetings, this should help residents keep up to date with the day to day running of the Home, and help ensure their views are listened to and acted upon. The environment looked satisfactorily maintained throughout. See also previous comments in this report concerning the service records for the lift, and fire safety equipment. The home carries out a health and safety audit of the whole environment on a three monthly basis. A copy of the document that is used to carry out the audit was inspected, and this document was very detailed and aimed to address health and safety areas through the Home. There is a health and safety policy for staff to follow to try and help ensure the safety of residents is maintained. Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 20 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 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 4 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X X X 3 Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 21 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. Refer to Standard Good Practice Recommendations Riversway Nursing Home DS0000020285.V270135.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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. 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