CARE HOMES FOR OLDER PEOPLE
Riverview Stourton Road Ilkley West Yorkshire LS29 9BG Lead Inspector
Gillian Sangster Unannounced Inspection 27th October 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 Riverview DS0000019902.V260306.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. Riverview DS0000019902.V260306.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Riverview Address Stourton Road Ilkley West Yorkshire LS29 9BG 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) 01943 602352 01943 602352 Ilkley Healthcare Limited Mrs Christine Rickerby Care Home 61 Category(ies) of Past or present alcohol dependence (1), registration, with number Dementia (1), Dementia - over 65 years of age of places (61), Mental disorder, excluding learning disability or dementia (1), Mental Disorder, excluding learning disability or dementia - over 65 years of age (6), Physical disability over 65 years of age (1) Riverview DS0000019902.V260306.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 2nd November 2004 Brief Description of the Service: Riverview is a large, detached property in Ilkley with car parking at the front of the home. Public transport routes and local amenities are nearby. The accommodation is on four floors with two lifts accessing all areas. There are five lounges, two of which are used as dining rooms and activity areas. There are extensive gardens including a small enclosed area accessible to residents. The home provides nursing care for up to 61 older people with dementia. Riverview DS0000019902.V260306.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by two inspectors between 9.30am and 12.30pm. Most of the core standards were covered at the last inspection and therefore this visit followed up on requirements and looked at the remaining core standards. We spent time looking round the building, talking with residents and staff in communal areas and observing practice. We looked at records relating to care planning, assessment, duty rotas, medication and residents’ financial records. We were unable to access staff recruitment records so these will be looked at during the next visit. The improvements noted at the last inspection have been maintained. What the service does well: What has improved since the last inspection?
Suitable door locks have now been fitted to all bedrooms. The broken glass in the conservatory has been replaced. Accident reports are now filed separately in each resident’s file. The smaller lounge has been redecorated and made more homely providing a much nicer environment. Riverview DS0000019902.V260306.R01.S.doc Version 5.0 Page 6 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. Riverview DS0000019902.V260306.R01.S.doc Version 5.0 Page 7 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 Riverview DS0000019902.V260306.R01.S.doc Version 5.0 Page 8 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): Standards 1 and 2. The home provides good, up-to-date information so that people can make an informed choice about moving in. Residents’ needs are assessed before admission to make sure that they can be met. EVIDENCE: The home has a detailed statement of purpose and service user guide, which provides good information about the facilities and service provided and was last reviewed in August 2005. This information is available to residents and relatives. The manager and senior staff endeavour to visit and assess all residents before they are admitted to the home to make sure they can meet their needs. Preadmission assessments were seen for three residents. These provided detailed information about the residents and were supported by other assessment information provided by the care management team. Riverview DS0000019902.V260306.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): Standard 7 and 9. Care plans are well recorded so that staff are clear about the action they need to take to meet the residents’ needs. Medication systems are safe. EVIDENCE: Three residents’ care records were looked at. All contained detailed information showing clearly the action staff needed to take to meet the resident’s needs. One resident’s care plan gave good information for staff about how to manage challenging behaviour ensuring a consistent approach. Care plans had been discussed with relatives and showed evidence of regular review. One resident had been discharged from hospital with a wound and there was detailed information about the treatment and management of the wound. Risk assessments are recorded for falling, risk of pressure ulcers, moving and handling and nutrition. These were well recorded and up-to-date. Staff showed a good understanding of the individual needs of the residents. The home has safe systems in place to manage medication. Contractual arrangements are in place for the safe disposal of medicines. It is recommended that the home keep a record of what they have put in for
Riverview DS0000019902.V260306.R01.S.doc Version 5.0 Page 10 disposal so that all medicines can be accounted for. Medication administration charts were well completed with individual photographs attached of each resident to aid identification. Riverview DS0000019902.V260306.R01.S.doc Version 5.0 Page 11 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): Standard 12. The home provides a good range of activities to meet the needs of the residents. EVIDENCE: A range of activities are offered at the home. The home employs an activity co-ordinator who organises activities and outings for the residents. An arts and crafts lady visits regularly and there were examples on display of pictures and ornaments the residents had made. Some of the residents enjoy walking around the home and are able to do so freely with staff discreetly keeping an eye on their whereabouts. On the day of the inspection the residents were given time to have a leisurely breakfast. Most then made their way to the communal areas where old time records were being played. Many of the residents were singing along and obviously enjoying themselves. Staff were on hand to offer assistance and spend time chatting to service users. This helped to create a calm atmosphere and staff could quickly intervene if conflict arose. One of the small lounges where the more dependent residents tend to gather has been redecorated since the last inspection. This now provides a cheerful and comfortable environment with pictures and comfortable seating. Riverview DS0000019902.V260306.R01.S.doc Version 5.0 Page 12 Riverview DS0000019902.V260306.R01.S.doc Version 5.0 Page 13 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): These standards were not assessed at this visit. EVIDENCE: Riverview DS0000019902.V260306.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): Standards 19, 22, 24 and 26. Maintenance works must be identified and addressed promptly. Bedrooms provide comfortable and personalised accommodation. The home is kept clean. EVIDENCE: The home is divided into two parts, which are linked together with keypad doors in the connecting corridors. The bedrooms are maintained to a good standard of hygiene and cleanliness. Many of the bedrooms have been personalised by service users and relatives. Suitable doors locks have been provided for all bedroom doors. The broken glass in the conservatory has also been replaced. A number of minor repairs were noted. These include the following: Ground Floor Room 2 - the plaster around the inside of the bedroom door must be repaired. Room 6 - the light switch knob must be replaced.
Riverview DS0000019902.V260306.R01.S.doc Version 5.0 Page 15 First Floor Room 12 - the odour in this room must be addressed. Room 1 - the light switch knob and the missing drawer handle must be replaced. Third Floor Room 26 - the missing drawer handle must be replaced. Rooms 10 and 11 - serious water damage was noted in both these bedrooms. The en-suite in one room was particularly badly affected, with water damage around the light switch. This area must not be used until the damage has been repaired. The water damage in the bedroom next door is located above a resident’s bed. Alternative accommodation must be found for the resident until the damage is repaired. A variety of hoists and lifting aids are provided and many of the beds are fitted with safety rails. Riverview DS0000019902.V260306.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): Standards 27 and 29. Staffing levels are maintained at the agreed levels. EVIDENCE: Duty rotas showed that staffing levels are maintained at the levels agreed with the provider. No concerns were raised about the staffing. Staff recruitment information was not available on the day of the inspection. The person on duty did not have access to the records. Riverview DS0000019902.V260306.R01.S.doc Version 5.0 Page 17 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): Standard 35. Residents’ financial interests are safeguarded. EVIDENCE: Payment for fees is made either by direct debit or cheques. Personal allowance is paid direct to only one resident and records are kept. The home looks after the valuables for some residents. Records were kept for the majority of residents, however no record was available for two recent admissions. These must be brought up to date. Riverview DS0000019902.V260306.R01.S.doc Version 5.0 Page 18 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 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Riverview DS0000019902.V260306.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP19 OP31 Regulation 23 18 Requirement Timescale for action 15/12/05 The maintenance works identified in this report must be completed. The registered manager must 31/12/05 obtain a recognised management qualification. 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 Refer to Standard OP9 Good Practice Recommendations A list should be kept of all medicines sent for disposal. Riverview DS0000019902.V260306.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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