Inspection on 11/08/09 for Riverview Residential Home

This inspection was carried out on 11th August 2009.

CQC found this care home to be providing an Adequate service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Riverview Residential Home 30/07/08

Riverview Residential Home 14/02/08

Riverview Residential Home 18/09/07

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report CARE HOMES FOR OLDER PEOPLE Riverview Residential Home 1 Hayfield Cottages Tittensor Road Tittensor Stoke-on-Trent Staffordshire ST12 9HG Lead Inspector Pam Grace Key Unannounced Inspection 11th August 2009 10:30 DS0000070051.V377123.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Riverview Residential Home Address 1 Hayfield Cottages Tittensor Road Tittensor Stoke-on-Trent Staffordshire ST12 9HG 01782 374 451 01782 374 451 bellasingh@hotmail.co.uk 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) Mrs Rishpal Singh Manager post vacant Care Home 8 Category(ies) of Old age, not falling within any other category registration, with number (8) of places Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only - Code PC To service users of the following gender: either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is 8. 30th July 2008 2. Date of last inspection Brief Description of the Service: Riverview is a residential home located in Stoke On Trent, Staffordshire, providing a service for eight older people. The two-storey property is located in a rural area with picturesque views, eight single occupancy bedrooms are provided on the ground and first floor level, six of which are equipped with en suite facility. One bathroom having an assisted bath is located on the first floor, a separate toilet facility is also provided on the ground floor. The home also consists of a lounge/dining area located on the ground floor, equipped with essential furnishings and fitments to provide a comfortable area for relaxation and to interact with people living in the home. A kitchen and a separate laundry are in place. There is a stair lift to assist individuals who have limited mobility. The fees for this service range from £425.00 to £431.00 weekly. The fee information included in this report applied at the time of inspection, the reader may wish to obtain more up to date information from the care service. Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This key unannounced inspection was carried out over one day, by one inspector. The inspection had been planned using information gathered from the Care Quality Commission (CQC) database, the Annual Quality Assurance Assessment (AQAA) document that had been completed by the provider, comments and surveys received from people who use the service and their relatives. The key National Minimum Standards for Older People were identified for this inspection and the methods in which the information was gained for this report included case tracking, general observations, document reading, speaking with staff, people who use the service and their visiting relatives. Observation of the environment was also undertaken. The Statement of Purpose and Service User Guide had recently been reviewed and were available for us to view. The previous inspection report is available to read in the main entrance hallway of the home. At the end of our inspection, feedback was given to the provider, outlining the overall findings of the inspection, and giving information about the requirements and recommendations that we would make. People spoken with were very positive about the care they were receiving. Our observations showed that these people were well cared for, and were happy in their surroundings. There had been no complaints or Safeguarding referrals made to or by the home, since the previous inspection. Surveys returned to the Care Quality Commission (CQC) totalled five `Have Your Say’ documents. The feedback and comments we received from people about the service were generally positive. There was one requirement, and seven recommendations made as a result of this unannounced inspection. Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 6 What the service does well: The home provides a comfortable and homely place to live where people feel part of an extended family. Care Plans are person centred and focus on meeting the specific individual needs of each person. Individual diverse needs are met well. These are reflected in the care plans and the environment is adapted to meet these needs. The home promotes individuality, autonomy and independence. What has improved since the last inspection? The Annual Quality Assurance Assessment (AQAA) completed by the provider told us about the following improvements: “More training and knowledge of how to achieve better results. We have raised awareness in getting documents supplied into different formats for service users Updated individual care plans and risk assessments. Updated our policies and procedures More training for staff. More knowledge about the community. Continue to offer a range of activities. Families are involved in birthday parties and special dos. Our polices and procedures have been updated. Staff have had training in regards to POVA. Questionnaires have continued to be evaluated on a regular basis. Health and Safety audit tool. Health and safety checks around the home are up to date with relevant certificates. The building from the outside has been painted. The garden fence has been painted. A new sign has been ordered and is in the process. Risk assessments have been updated. The home has purchased new garden furniture 3 bedrooms have been redecorated. All staff have NVQ level 2 in care, but for 1 new member. Waking staff for night shift. We have implemented a supervision process. A staff psychometric test is in place, for use during interview. Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 7 Updated our service user quality questionnaires in order to gain more understanding of how the home is meeting their needs.” What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 8 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 Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 9 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 - People using the 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 who may use the service and their representatives have the information needed to choose a home that will meet their needs. EVIDENCE: The Annual Quality Assurance Assessment document (AQAA), which was completed by the provider, told us: “Each service user has to have a pre-admission assessment. Service users are given a copy of our brochure, service user guide and statement of purpose which contains a copy of our complaints procedure. Service users and their families are given the opportunity to vist the home before a decision is made, or if this is not possible, the management will visit them instead. Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 10 The home offers a settling in period, and both parties can then reassess the placement after this time. The home ensures an individualised package of care is planned which is evaluated on a regular basis. A written contract will be supplied to a service user, once they are accepted for the placement, stating their rights and responsibilities. The home gives notice of any change of fees.” We were given copies of the Statement of Purpose and Service User Guide to look at. We saw that these documents had been reviewed. The previous inspection report was readily available in the entrance hallway, for people to look at. People spoken with, and feedback from surveys undertaken confirmed that they had received appropriate information prior to admission, which had included the Statement of Purpose. That they had been able to visit the home, and spend time talking with people who use the service to help them decide if the service would be suitable for them. People also confirmed that they had been provided with a contract/terms and conditions. The provider confirmed that contracts had all been reviewed. We looked at three care plans. These showed that an assessment of needs had been undertaken for those individuals prior to admission to the home. Intermediate care is not provided in this home. Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 11 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 - People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. EVIDENCE: The Annual Quality Assurance Assessment document (AQAA), which was completed by the provider, told us: “Each of our residents are supported to make their own decisions and care plans are implemented to support this. With agreement from the service user we work with the service users, families and other health liaisons to provide the best possible support for the individual. Staff are trained in giving choice to service users. We support service users to manage their own healthcare, and where this not possible we aim to identify any health problems so that they can be dealt with promptly. Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 12 We have care plans and risk assessments in place to identify those at risk and what action is being taken to reduce that risk. Service users can register with a GP of their choice. The home has a policy for the receipt, storage and handling, administration and disposal of medication, and the manager ensures this is carried out. Service users privacy and dignity is respected by all staff members and this is taught within training.” We examined three care plans. We spoke with staff, people who use the service, and their visiting relatives. Staff spoken with could tell us exactly how each of these people were to be cared for, what these staff told us reflected what was written in individuals care plans. People we spoke to told us they had been involved in their care planning processes and their review. Care plans seen contained evidence of pre-admission assessments, which had informed the care plan. There was also evidence of health professional’s involvement, for example District Nurse, General Practitioner, Chiropodist. Brief details were recorded in the event of terminal illness. Risk assessments and activities of daily living had been reviewed on a monthly basis. The provider confirmed that the tissue viability specialist nurse would be consulted where necessary in relation to a person requiring more complex treatment. District nurse records were evident in relation to wound care and treatment given to people using that service. Those records were kept separately in individual’s bedrooms. During our visit, a District Nurse was able to talk to us. She confirmed that she was treating two people at the home, who needed dressings. She reported no problems with the home in regard to staff attitude and competence, which she said was always satisfactory. She said “I am happy with the care of these two people, they are very well looked after, as are all the people living here.” People spoken with during our visit said that they were satisfied with the care they receive. Comments received included the following, “I am happy here.” “I can’t think of anything that can be done better.” “It is a very good and friendly home.” “It is very friendly, and the staff as well, and I enjoy being here.” “Satisfies me, I’m satisfied, I wouldn’t have been here 8 years if I was not satisfied.” A spot check of the home’s medication systems evidenced satisfactory and safe practice of medication administration, storage and disposal. The medication administration system has significantly improved since the previous inspection, and included daily checks and monthly audits by the provider, and six monthly audits by the pharmacist, this ensures the health, welfare and safety of the people using the service, and that staff are competent. The policy and procedure for medication was recently reviewed, and staff spoken with confirmed that they had received appropriate medication training. Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 13 Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 - People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service should be enabled to make choices about their life style and should be supported to develop their life skills. Social, educational, cultural and recreational activities must meet individual’s expectations. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) document, which was completed by the provider, told us: “We have regular residents meetings. We have open visiting arrangements for the families. We encourage our residents to do daily activities and get involved in cooking e.g. a cake, gardening or activities of their choice. The home offers 3 meals a day, including snacks and drinks throughout the day. Special diets for the diabetics and vegetarians are catered for. Religious needs are met Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 15 The home implements person centred care plans, treating service users as individuals. The home has areas where service users can meet with families, friends or health professionals on a private basis. Each service users’s bedroom has a private phone line. The home will accommodate as much as possible service users personal possessions, which they may wish to bring into the home. Residents handle their own financial affairs for as long as they wish, and have the capacity to do so.” We spoke with people using the service, and their visiting relatives. Comments received included the following: “A bit more variety of the menu is needed.” “More fresh food, and more of an English diet.” “They could provide a more varied and nutritious meal plan. Provide regular activities – internal and external. Take advantage of community activities and invites. Be less institutionalised, therefore, discard set times for drinks.” “The menu is uninteresting, and not varied enough.” “We sometimes don’t know what we’re having.” People spoken with confirmed that they were able to have their say, as there are regular meetings for people using the service. We saw evidence of this through the records of those meetings. We saw that daily records kept on each individual included the activities undertaken that day. We found that care staff were responsible for providing people with activities each day. There were two care staff on duty at any one time. Staff confirmed that they provided activities when time allows. For example playing cards, jigsaws, crossword puzzles, quizzes, bingo. There is no daily newspaper delivered. There is no visiting library service. However, one person told us that he does receive talking books each week. We saw that the lounge is small, and there were too many armchairs in there, which resulted in a feeling of being squashed in. People using the service eat in the lounge/diner, either on small tables, or seated at a round table, which takes up a lot of space. We highlighted this, and discussed the need to take at least two chairs out to make space for people, and to change the round table for a longer slimmer table, which would also make more space for people. People told us that they don’t go out much. They said they need transport, to take them on trips out. They also said that they don’t know what is happening locally, for example at the local church, community centre or the shops. Four weekly rotational and seasonal menus were in place. We looked at the kitchen, which was very clean and tidy. Records seen confirmed that all hot and cold food temperatures are taken daily and recorded. We discussed the Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 16 need for people to have a say in the menu, and to have the menu available in large print, posted up on the notice board, so that people can see what is on offer each day. We were told that meals are sometimes substituted for something else, and are not what is written on the menu. We also suggested some more variety in the menu. We were told that lunch and evening meal had been swapped over, and that this change was working well. Dinner is now taken in the evening and a lighter lunch served in the middle of the day. However, the menu times did not reflect the change made, and the print on the menus was too small for people to see. Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 - People using the 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 who use the service are able to express their concerns, and have access to a robust, effective complaints procedure. People are protected from abuse, and have their rights protected. EVIDENCE: The Annual Quality Assurance Assessment document completed by the provider, told us: “The home has a clear complaints procedure illustrating time scales and how complaints are dealt with. All residents are informed of the concerns/ complaints procedure and would be fully supported by staff in making their complaint The home keeps a copy of all complaints and concerns received and the action which will be taken.The home adopts the opinion that each resident has the capacity to make all their decisions unless proved otherwise.Residents and relatives can be provided with advocacy service information. Procedures are in place to respond to evidence or suspicion of neglect.” Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 18 The provider confirmed that people who use the service and or their representatives are provided with a copy of the home’s complaints procedure during the admission process. People spoken with during the inspection visit confirmed that they had been given a copy of the complaints procedure, and knew who to complain to. They said that their grumbles are listened to and acted upon by staff. Staff spoken with confirmed that the home has an open door policy in regard to complaints. There had been no complaints since the last inspection, and no Protection of Vulnerable Adults (POVA)/Safeguarding referrals had been made to Social Services. We spoke with staff, and looked at the training matrix. Staff had received training with regard to adult abuse, its identification and types of exploitation. There is a safe and secure system in place in regard to monies held by the home, on behalf of the people using the service. Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23 and 26 - People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people who use the service to safely live in a homely and comfortable environment, which encourages independence. The lounge/diner area would benefit from a more appropriate dining table, and a review of the layout to create more space for people using the service. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) document, completed by the provider, confirmed that all health and safety checks on equipment and fire systems had been undertaken, and told us: “We ensure that the environment is well maintained and offers residents a homely place to live. Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 20 The home is maintained appropriately to reduce the risk of infection and cross infection. The staff are trained in infection control. A programme of routine maintenance is kept within the home The home complies with the recommendations of the local fire service. Communal space is available within the home for all residents to access. The home has outdoor space which is accessible to all residents including those with mobillity problems Toilet and bath facilities meet the needs of the residents. Adapted equipment is provided around the home for those residents with limited mobility The home provides private accommodation for each resident which is furnished to a comfortable standard Each room is centrally heated with controls in each room.” The AQAA also told us about the improvements that had been made since the previous inspection, these were as follows: “Health and Safety audit tool Health and satety checks around the home are up to date with relevant certificates. The building from the outside has been painted The garden fence has been painted. The new sign has been ordered. Risk assessments have been updated. The home has purchased new garden furniture 3 bedrooms have been redecorated This work was confirmed and seen during our observation of the building. People spoken with during the inspection visit expressed their satisfaction with the general environment, their room, and the equipment provided within the home. People spoken with said, “it’s kept clean and tidy”, and “the staff try very hard to keep it all clean.” During observation of the environment we saw that the home provides a clean, well-maintained environment throughout. The lounge area is in need of redecoration. However, this was already known to the provider and was in hand. We also observed that people do not use the rear garden area, and tend to sit at the front of the building within the car parking area. We discussed the need for more activities in the garden, and to have more garden furniture outside, which would encourage people to use the garden. Individual accommodation is personalised to suit the people using the service. One person told us that he “had his furniture arranged in such a way that he knew where everything was.” The lounge/dining area would benefit from the removal of some chairs, and the purchase of a narrow dining table, which would give people more space, and Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 21 encourage more people to eat at the table. The communal areas are comfortable and homely. Bathrooms and toilets are conveniently sited around the home. We saw that equipment and adaptations were provided as necessary to maximise independence. For example, wheelchairs, raised toilet seat, handrails, and assisted baths. Kitchen and laundry areas were clean and tidy, with appropriate measures in place to prevent cross infection. Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 22 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 - People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There should be enough staff in the home to safely support the needs of the people using the service. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) document, completed by the provider, told us: “The home ensures that all staff operate in a manner which promotes liberty We enable users to feel safe and secure whilst promoting independence As an organisation we recruit in a fair and open way ensuring we employ the right people. We undertake a robust recruitment process and carry out various checks on possible employees, e.g. POVA, CRB references All workers receive a job description and handbook All staff receive induction training and regular updates. All staff have appropriate experience and qualifications, and have completed their NVQ level 2 in care. 1 staff member has started her NVQ level 3. The home displays a rota which shows what staff are on duty at what times.” Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 23 Comments received from people using the service are as follows: “It is very friendly and the staff as well, and I enjoy being here.” “The care staff have developed good relationships with the residents, and endeavour to provide a safe, secure environment.” The staff rota for the end of July and beginning of August 2009, confirmed that there are two members of staff on duty at all times during the day shifts. At night we were told that the home has one waking member of staff, and one sleeping member of staff on duty. However, the duty rota did not evidence this. This was highlighted and discussed with the provider at the time. It is recommended that a named sleeping member of staff should be included in the rota, and on duty each night, to ensure the safety of the people using the service. Staff, people spoken with during the inspection visit, and surveys received from people who use the service, confirmed that staffing levels had been maintained. We were told that staff are responsible for laundry, cooking and cleaning in the home, this is as well as caring for the people using the service, and for providing activities. However, we saw that activities only run if staff have time. Staff spoken with confirmed that staff meetings were being held approximately three monthly, and that supervision of staff was being held every eight weeks, as per the National Minimum Standard. They confirmed that they had received updates in regard to mandatory training, including moving and handling, health and safety, Fire and Medication. However, we were shown a copy of the home’s staff training matrix, which was not up to date, and did not clearly evidence the training undertaken. Some certificates gained for courses already undertaken by staff, were also missing from records. This was highlighted and discussed with the provider at the time. The provider confirmed that further training for staff in regard to Safeguarding and the Protection of Vulnerable Adults (POVA) will be undertaken in October or November 2009. Three staff recruitment files were examined. These were uniformly completed and contained all of the appropriate security/police checks. Records evidenced a good standard of procedures from an administrative point of view. Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 24 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 - People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users and staff need consistent leadership and management, and a manager who is registered with the Care Quality Commission. The home should further develop its quality assurance system to make sure that services are provided in the best interests of those who use them. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) document, which was completed by the provider, was returned to the Care Quality Commission Inspection on time, and was adequately completed. Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 25 The Annual Quality Assurance Assessment document told us: “All workers have induction training and then yearly appraisals to identify their learning needs. Staff undertake supervision at least 6 times a year.The manager has 2 years managerial experience and has completed her Leadership and Management. NVQ 4 in Health and Social Care Adults. The home has a clear management structure approprate for its size Records are kept to safeguard interests for at least 3 years from the last entry. The home has up to date polices and procedures Residents are able to access their records if they wish We provide a safe place for residents to keep valuables or money and a record of this is maintained.” We have not yet received an application in respect of registration of the manager for this home and it is required that this be addressed without further delay. The provider is qualified and has the necessary experience to run the home. She is aware of and works to the basic processes set out in our regulations, and is aware of the need to keep up to date with practice and continuously develop her management skills. However, there is currently not enough management time put into the service, to support the staff team, and to ensure the health, safety and welfare of the people using the service. We strongly recommend that at least 30 hours management time is undertaken by the provider. The provider trains and develops staff that are generally competent and knowledgeable to care for the people using the service. The home focuses on the individual, takes account of equality and diversity issues, and generally works in partnership with families or close friends and professionals, as appropriate. The Provider had started to develop a Quality Assurance system; starting with questionnaires for people who live there. This now needs further development so that all the services offered by the home can be quality assessed and continually improved. The system needs to include all stakeholders, and outcomes should be collated, then feedback to staff, relatives and the people using the service, along with any actions to be taken by the service. Formal staff supervision has been established at the home, and the provider continues to develop this in order to help ensure that staff are supported, safe and competent, and that this is monitored. A spot check of four people’s finances showed no anomalies, figures seen tallied with amounts held, and receipts are kept for all purchases made on people’s behalf. Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 26 Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 3 X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 3 X 2 Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 28 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 OP31 Regulation 8 (1) Requirement The registered provider must appoint an individual to manage the care home where there is no registered manager in respect of the care home and is not, or does not intend to be in full time day to day charge of the care home. Timescale for action 31/10/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP12 OP12 OP12 OP12 Good Practice Recommendations People using the service should be consulted on what they would like on their menu, thus ensuring that they have their say. Meals served should reflect what is written on the menu, changes to the menu should be noted, and should include the reason why. Menus should be available in large print, and clearly displayed for people using the service. The programme of activities would benefit from being further developed to include trips out for people who wish DS0000070051.V377123.R01.S.doc Version 5.2 Page 29 Riverview Residential Home 5. 6. OP27 OP31 to go. Staffing levels should be increased during the afternoon to enable activities for the people using the service. The Provider should submit an application for Registered Manager for the home in order to ensure continuity of management. The Quality Assurance system should be further developed so that all the services offered by the home can be quality assessed and continually improve outcomes for people who live at the home. 7. OP33 Riverview Residential Home DS0000070051.V377123.R01.S.doc Version 5.2 Page 30 Care Quality Commission Care Quality Commission West Midlands Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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