Inspection on 07/02/07 for Riverview

This inspection was carried out on 7th February 2007.

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

Riverview 05/05/10

Riverview 02/02/10

Riverview 04/02/09

Riverview 26/07/06

Riverview 27/10/05

Riverview 02/11/04

Riverview 09/09/04

Riverview 27/04/04

Similar services:

Snydale Care Home

Staveley Birk Leas Nursing Home

Fairmount Nursing Home

Currergate Nursing Home

Brookfield

Castlethorpe Care Home

Elmleigh Convent

Woodlands Respite Care Centre

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

CARE HOMES FOR OLDER PEOPLE Riverview Stourton Road Ilkley West Yorkshire LS29 9BG Lead Inspector Mary Bentley Key Unannounced Inspection 7th & 8th February 2007 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 Riverview DS0000019902.V328921.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. Riverview DS0000019902.V328921.R01.S.doc Version 5.2 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 602380 Ilkley Healthcare Limited Mrs Christine Rickerby Care Home 61 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (61), Mental disorder, excluding learning of places 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.V328921.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th July 2006 Brief Description of the Service: Riverview is a large, detached property situated a short distance from the town centre in Ilkley. The home provides nursing care for up to 61 older people with dementia. The accommodation is on four floors with two lifts giving access to all areas. There are 20 shared and 21 single rooms; 17 rooms have en-suite facilities. There are six lounges, two of which are used as dining rooms and activity areas. There are extensive gardens including a small enclosed area that is accessible to residents. There are good public transport links and car parking is available in the grounds. In December 2006 the home told us the weekly fees were £495.00 with no extra charges. Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 we made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate”, and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk The last inspection was in July 2006 and there were 13 requirements. We have not made any additional visits to the home since then. The purpose of this inspection was to check on progress in dealing with the issues raised at the last inspection and to look at how the needs of people living in the home are being met. Three inspectors did this unannounced inspection over two days. In total we spent 25 hours in the home. During the visit we spoke to residents, relatives, staff and management, examined various records and looked at most parts of the home. On the second day of the visit, one inspector spent two hours in the morning in one of the lounges watching the care being given to a small group of residents. This included looking at how staff engaged with the residents and helped us to understand what daily life is like for the residents. Comment cards were sent to some relatives before the visit. Comment cards give people the opportunity to share their views of the service with us. The information we get is shared with the home without identifying who has provided it. Seven cards were retuned and showed that overall people are satisfied with the service. The information received is included in this report. What the service does well: The following are some of the comments made by relatives of people living in the home: “The home has a relaxed atmosphere”. “A good atmosphere exists at the care home, always pleasant staff.” Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 6 “Makes visitors feel welcome.” “I am always impressed by the levels of patience shown by the care staff”. “They are excellent at dealing with residents’ individual needs; they always make people feel wanted. They get the best out of all the residents and help them to make the best of themselves.” “I feel confident that the staff always treat my father with respect”. 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. The summary of this inspection report can be made available in other formats on request. Riverview DS0000019902.V328921.R01.S.doc Version 5.2 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.V328921.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 5. Standard 6 does not apply to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and/or their representatives are encouraged to visit the home before admission and are given the information they need to help them decide if the home can meet their needs. EVIDENCE: The Statement of Purpose contains all the required information and is made available to people when they are considering admission. The contracts (Terms and Conditions of residency) have been changed and now show the full fees to be paid. The owner said they are given to people at the time of admission. Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 9 Pre-admission assessments were seen in the care records. Relatives confirmed that someone from the home had visited prospective residents to do an assessment of their needs before they moved in. Relatives said they had been able to look around the home and most felt they had been given enough information to help them make a decision. One person said, “When we first considered Riverview we were shown the reports which weren’t all good. Nothing was hidden from us and we were we shown the procedure should we wish to complain.” Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 10 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): 7, 8, 9, 10 & 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal and health care needs are met in a way that respects their privacy and dignity. Some more improvements are needed to the care records to make sure that care continues to be delivered in a consistent way. EVIDENCE: We looked at the care records of five residents. Overall the care plans contain enough information to tell staff how needs should be met. They have some information on what people can do for themselves. The care plans are reviewed monthly but changes noted in these reviews are not always reflected in the care plans. For example one resident has a care plan about eating and drinking, which was done in 2004. The evaluation shows that this resident is now fully dependant on staff but this is not made clear in the care plan. Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 11 Some care plans had information about the type of incontinence products needed by residents and others did not. Risk assessments were in place for falls, nutrition, pressure sores, and moving and handling. In most cases the risk assessments were up to date. However, in the case of one resident the falls risk assessment had not been reviewed following a recent fall. Where residents were receiving treatment for pressure sores or wounds the care plans showed clearly what treatment was being used and showed the progress of the wounds. The records showed that residents have access to health care services, including GPs, dentists, opticians, dieticians, and physiotherapists. The majority of relatives said they were informed and consulted about residents’ care needs and felt that the home provided appropriate care. The daily records do not give a lot of information about the general wellbeing of residents’ or how they actually spend their time. There were some records of when people had visitors or when they were “unsettled” but phrases such as “settled night” and “no change, care as plan” were used repeatedly. This is an area that needs to be improved. At the last inspection we were concerned that some working practices in the home were not promoting the dignity of residents. These issues have been dealt with. One person who visits the home regularly said “It’s all about respect, people who live here are respected, it’s not about being polite, it’s about being able to have a bit of banter and not talking about people as if they don’t exist”. There are appropriate systems in place to make sure that medicines are managed safely. The relative of a resident who had recently died in the home said the staff had been very caring and supportive. She had been consulted about her relative’s end of life care and as well as giving her emotional support the home had helped her with the practicalities of arranging the funeral. Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 12 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): 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from the relaxed and comfortable atmosphere in the home and they are supported in keeping in touch with their families and friends. EVIDENCE: There is an activities file, which includes a list of events that have taken place, these include visits by entertainers, slide shows, church services, and there was a bus trip to Bolton Abbey in July. Someone visits the home to do an arts and crafts session every week, she said it is usually a small group of 4 or 5 and sometimes other people like to come along and watch what is going on. Each resident has an individual activities record showing what they have taken part in and this shows that activities are taking place regularly. Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 13 Daily routines are reasonably flexible and residents who prefer to spend time in their rooms are supported in doing so. Several people commented on the relaxed and friendly atmosphere in the home. One relative said “Riverview has freedom for the residents, if they can walk around they are encouraged to do so. There is a happy atmosphere.” During the inspection a small group of residents in one the lounges were observed. There were staff present in the lounge throughout this two-hour period and they were seen to be very patient and kind with the residents. Staff took every opportunity to engage with the residents and showed genuine concern for their wellbeing. Staff were particularly good at making sure that all the residents had regular contact and took the time to ask residents questions rather than making decisions for them. There was music playing in the room and some residents were singing along. Others were tapping their feet and watching one resident who was dancing with the staff. Some residents were reading magazines; others were walking around looking out of the windows watching the snow falling outside. Staff encouraged the residents to join in with the activities but also recognised that some residents just wanted to sit quietly. The attitude of the staff generated a feeling of warmth, fun and inclusion from which all residents benefited. Relatives said they can visit at any time and are always made welcome. At the last inspection we were concerned about the way mealtimes were managed for some residents. These concerns have been dealt with. We observed lunch being served on the first day of the visit. The tables in all the dining rooms had tablecloths, tablemats and paper napkins. The cutlery was set out as the meal was served. The food was well presented and drinks were provided. Staff helping residents to eat did so discretely; they sat facing residents and talked to them throughout the meal. The mealtime was relaxed and people were given plenty of time to enjoy their food, they said the food was good. Liquidised meals had each part of the meal liquidised separately so that residents could benefit from enjoying different textures and tastes. The cook has a good knowledge of residents’ dietary preferences and there is a record of any special diets that residents need. Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 14 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): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are given information about the complaints’ procedure and complaints and/or concerns are dealt with appropriately. There are systems in place to make sure that residents are protected from abuse. EVIDENCE: The home has not had any complaints since the last inspection and no complaints have been made to us. Information about the complaints’ procedure is available in the home. The majority of relatives said they had been told about the complaints’ procedure. One person said they had no need for the complaints’ procedure because they were kept informed. One relative said, “If I raise a concern then a senior member of staff will look into it and inform me of the findings”. Other relatives made similar comments. Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 15 The manager said that all the staff have done Adult Protection training. Staff are aware of how to report abuse or any concerns they have about the protection of residents. Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 16 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): 19, 22, 24, 25 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and provides a pleasant, comfortable, and safe place for people to live. EVIDENCE: The home was clean and for the most part was free of unpleasant odours. There was an odour in one room; staff were aware of this and trying to deal with it. One relative said the home mostly smells fresh, and there are just odd occasions when this is not the case. Another relative said the home was well maintained both internally and externally. Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 17 Overall the standard of décor and furnishings is satisfactory, some bedroom furniture needs to be replaced, the manager said there is an ongoing programme of refurbishment, and we saw evidence of this during the visit. There has been a big improvement since the last inspection in the way that residents’ bedrooms are looked after. Particular attention has been given to making sure that each resident has his or her own toiletries and that these are clearly identified. There has also been an improvement in the way residents’ clothing is looked after and in making sure that clothing is labelled so that residents’ get their own clothes. One relative thought the laundry was excellent however others felt more improvements were needed; two people said they felt the standard of ironing could be improved. Another person when asked what the home could do better said, “Reading labels on clothes and making sure people get their own clothing, clothes need to look better when they come from the laundry” In the majority of bedrooms residents’ had some personal belongings such as photographs, ornaments or items of furniture. There are call bells in all the rooms. The manager said the call bell leads had been removed from some rooms following a risk assessment. Evidence of this was seen in the care records. Some minor maintenance issues were identified and were dealt with during the visit. More attention should be given to making sure that clocks are working properly. The records showed that the hot water temperatures were checked in January 2007 and were satisfactory. No problems with hot water temperatures were identified during the tour of the building. Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 18 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): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. At the time of the inspection there were enough staff to meet residents’ needs. To make sure that this continues any changes to staffing levels must take account of the dependency needs of residents as well as the number of people living in the home. EVIDENCE: Duty rotas are available for all grades of staff. There are enough staff on duty to meet residents’ needs. The home has a stable staff team; many of the staff have worked there for several years. Some people said they found the low staff turnover reassuring. The home is divided internally into two sections and a core staff team is allocated to each section; the remaining staff work between the two areas. Relatives described the staff as friendly, helpful and caring. One person said, “staff always have time and a smile and it’s not put on”. Another said, “Staff are always ready to talk to me and they have a good sense of humour”. Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 19 Of the seven relatives who completed comment cards just over half said they thought staff had the right skills and experience to look after people properly. One relative said they thought the staffing at weekends could be improved; they felt there was not as many experienced staff on duty at the weekends. The owner is considering making changes to the staffing levels to reflect the number of people living in the home. Any proposed changes will have to take account of the dependency needs of residents and the layout of the building. Information provided showed that 50 of the care staff team are qualified to NVQ (National Vocational Qualification) level 2 or above; this meets the recommendations of the National Minimum Standards. The records showed that good recruitment procedures are used when new staff are employed, all the required checks are done before they start work in the home. At the last inspection we were concerned that CRB (Criminal Record Bureau) checks had not been obtained for all the existing staff. The home has been dealing with this, CRB checks have now been completed for all but three staff, and they have been applied for. The home has an ongoing training programme; the manager said she tries to have a training session every month. As well as mandatory training such as fire safety and moving & handling training has recently been provided on subjects such as skin care, wound management, safe management of medicines and positive dementia care. Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 20 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): 31, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, residents and their representatives are given the opportunity to put forward their views on the running of the home and the quality of the services provided. EVIDENCE: The manager is a nurse with many years experience. She will not be doing management training as she is planning to retire later this year. The owner has started the process of recruiting a new manager. Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 21 The manager does not have any supernumerary time and it is to her credit that she is able to manage such a large and busy home with the limited time resources she has. One relative said she had made “a great improvement” to the home and another said, “The manager is very good”. The home sends surveys to people every year, they were last issued in April 2006, and 17 people responded. All the people who responded said they were happy with all aspects of the home. They said they found it “calm, and relaxing”. Everyone thought their relatives looked well cared for and that the staff were always smart and clean. Staff meetings are usually twice a year; the last one was in August 06. The meeting focused on the last inspection and how the issues raised would be dealt with. The owner carries out monthly visits and looks at various aspects of how the service is working; we get copies of the reports following these visits. The home collects pension money on behalf of one resident, the issues raised at the last inspection have been dealt with, and there are clear records of all transactions. The records showed that the equipment and installations are checked and serviced at the required intervals. The fire alarm system is tested weekly. Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 22 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 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 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 3 X 3 3 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 23 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. 1 Standard OP7 Regulation 14 & 15 Requirement The assessment of needs must be reviewed and updated to take account of changes in residents’ conditions and the care plans must be updated to reflect these changes. Timescale for action 29/06/07 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 The home should sign the disclaimer forms on the back of all prescriptions for residents who are unable to do this. Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Riverview DS0000019902.V328921.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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