Inspection on 14/02/08 for Riverview Residential Home

This inspection was carried out on 14th February 2008.

CSCI found this care home to be providing an Poor service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Riverview Residential Home 11/08/09

Riverview Residential Home 30/07/08

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Riverview Residential Home 1 Hayfield Cottages Tittensor Road Tittensor Stoke-on-Trent Staffordshire ST12 9HG Lead Inspector Dawn Dillion Key Unannounced Inspection 14th February 2008 10:10 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 Residential Home DS0000070051.V357395.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 Residential Home DS0000070051.V357395.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 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 Vacant post Care Home 8 Category(ies) of Old age, not falling within any other category registration, with number (8) of places Riverview Residential Home DS0000070051.V357395.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. 18th September 2007 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 suit 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 homes Service User Guide identifies that the fees for the service and provision is £380.00p per week. This information was correct at the time of this inspection. The reader may wish to contact the service for more up to date information. Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. The unannounced Key Inspection of Riverview was undertaken within five hours. The inspection methodologies that were used, to establish the quality of the care provided and the effectiveness of the management of the home, to promote equality, diversity and best practices, entailed the examination of records, relating to the homes policies, procedures and general practices. Four people that use the service were interviewed during the process of the inspection, to gather their views and experience of living in the home. An inspection of the premises was undertaken, to ensure that the environment and systems in operation were safe and suitable, to meet the needs of people living in the home. The home was currently without a Registered Manager; the Registered Provider was present for the duration of the inspection. What the service does well: What has improved since the last inspection? Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 6 Care plans were more informative relating to the care needs of the individual and the level of support and assistance required. There was a lack of compliance with requirements identified within the previous inspection report. The outcome for people living in the home remains poor; hence, it was difficult to establish if there had been any significant improvements since the last inspection visit. What they could do better: During the process of the inspection it became evident that there was noncompliance regarding requirements identified within the previous inspection report, two out of eight had been addressed. The home did not have a pre admission assessment tool to ensure that the home would be able to meet the needs of people wishing to access the service. Care plans were not reviewed on a regular basis to reflect the individuals changing needs. Poor medication systems and practices compromised the health and welfare of people. There was a lack of evidence of meaningful social activities or a management style that promoted people’s rights and independence. The homes complaint procedure was not readily accessible to all people living in the home, there was no safe guarding protocol in place and discussions with the Registered Provider identified a lack of knowledge regarding adult protection. The homes staff recruitment procedure failed to ensure the safety and protection of people living in the home. One out of seven staff members had obtained the National Vocational Qualification Level 2 in care. There was a lack of emphasis focused on staff training, development and supervision to ensure that people receive a good standard of care. The home maintained a small amount of cash in safekeeping for people living in the home. The homes financial procedure was not robust to ensure the safe accounting of people’s finances. With reference to health and safety a requirement was identified within the previous report that a restrictor was required to be fitted to the bedroom Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 7 window located on the first floor, the home failed to comply with this regulation. There was also non-compliance to guard a radiator to protect an individual from the hot surface. 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 Residential Home DS0000070051.V357395.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.V357395.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Whatever reason people wishing to access the service, they are provided with relevant information to enable them to establish if the home would be suitable to meet their needs. People wishing to access the service may not be provided with the appropriate level of care, to ensure their general health and welfare. EVIDENCE: Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 10 The homes Statement of Purpose and Service User Guide provided relevant information relating to the service and provisions available within the home. The Registered Provider informed us, the Commission for Social Care Inspection, that a pre admission assessment would be undertaken prior to a placement being offered. There was no evidence of any written admission procedure, protocol or assessment tool in place. A brochure was in place, which provided brief information about the level of care offered at the home and the catering service. The registered person should ensure that consent has been obtained from people whose photographs have been used in the brochure. People wishing to access the service were able to visit the home prior to a placement being offered. During the process of the inspection a relative visited the home in view of a respite placement for her mother. The registered person should ensure that if the home is providing a respite service, this information should be included within the Statement of Purpose. Riverview Residential Home DS0000070051.V357395.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The lack of review of peoples care needs and poor medication practices has a negative impact on the service delivery, failing to promote the individual’s health and welfare. EVIDENCE: Three care plans were randomly selected for examination; all provided relevant information relating to the individuals care needs. One care plan provided in depth information relating to the level of support and assistance an individual required due to their visual impairment. Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 12 There was evidence that one person had access to the Diabetic Clinic for routine health checks. One care plan identified a person suffering with memory loss with no clear clinical diagnosis. Discussions with the Registered Provider confirmed that this individual did not have access to a Community Psychiatric Nurse, with reference to an up to date psychiatric assessment, to ensure that they were provided with the relevant care and support to promote their physical and mental health needs. With regards to continence management, the Registered Provider informed us that one person had had a continence assessment; there was no evidence of this on record. The registered person should ensure that this person has access to a Continence Adviser to guarantee that they are provided with the appropriate aids to promote their dignity and independence. There was no evidence that people were involved in the development or review of their care plan to reflect the individual’s choice, culture and general lifestyle. There was also a lack of consistency in ensuring that care plans were reviewed on a regular basis to reflect the changing needs of the individual. One person living in the home was registered blind and took responsibility for their medication. There was a risk assessment in place regarding medication which, failed to identify the persons sensory impairment, there was also no information in place about the level of support and assistance the individual required, to ensure that they were able to administer their medication safely. There was no protocol in place to ensure that the medication was being taken at the stated dosage and intervals as directed by the prescribing General Practitioner. The home operated the Vanalink monitored dosage system, the examination of records relating procedures and the observations of practices, confirmed that people living in the home did not receive their medication has directed by the prescribing General Practitioner, to promote the individuals general health. Medication administration records identified in one case that a person was not receiving their stated dosage of medication. The Registered Provider informed us, that this was due to instructions from the General Practitioner. This information had not been recorded in the care plan. Eye drops and ointments were not contained within the original box; hence there was no information to who these medication was prescribed for, or any directive to the dosage and the intervals for administration. Eye drops had not been dated to identify when they had been opened, to ensure that they were disposed of within 28 days as indicated on the container. It is also of concern that a number of medication was stored in an unsecured fridge in the kitchen, of which was accessible to people living in the home. Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 13 There was no protocol in place for the use of ‘when required’ medicines to ensure that staff are aware of when these medicines should be administered, the dosage, intervals or what action to take if the medication is not affective. Riverview Residential Home DS0000070051.V357395.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lack of consideration focused on social activities failed to ensure that people were able to live a lifestyle of their choice. The homes menus ensured that people’s nutritional needs were met to promote the individual’s general health. EVIDENCE: The general routine within the home continued to appear relaxed with people engaging in pastimes of their choice, which consisted of reading the newspaper and interacting with other people. The examination of staff rotas evidenced that there were insufficient care hours to support individuals in social activities of their choice. Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 15 There were no individuals in residence from the ethnic minority group; care plans identified that there were a number of people from various religious groups. The Registered Provider informed us that no one in the home had expressed a desire for any specific assistance to practice his/her religious/spiritual faith. People living in the home were able to receive visitors at any time within reason, to enable them to maintain contact with their family and friends. During the process of the inspection, four people living in the home were interviewed, all confirmed their satisfaction with the support provided by staff and were happy with the service and facilities provided in the home. The Registered Provider informed us that meetings were undertaken with people who access the service. There were no written minutes available to evidence this. Discussions with one person living in the home confirmed that, “The food has not changed, it is still good.” “I would like to go out for walks to get more exercise.” The examination of menus identified that a well-balanced nutritional diet was provided; the Registered Provider informed us that there were no special dietary requirements due to religion or culture. During the process of the inspection, a care staff was observed giving an individual who was registered blind their meal. The carer failed to inform the person what the meal consisted of or where the food was located on the plate. Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 16 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 and 18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People living in the home do not have a copy of the homes complaint policy to enable them to share any concern/complaints. The individual’s welfare is compromised by the homes poor recruitment practices that do not guarantee protection from abuse. EVIDENCE: There was a complaint procedure in place, which was located on the wall in the main entrance of the home. Consideration should be given with the publication format to accommodate people who have a visual impairment. The document should also be reviewed to ensure that it provides the correct contact detail for the Commission for Social Care Inspection. The Registered Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 17 Provider informed us that people who accessed the service did not have a copy of the complaints procedure. The homes Statement of Purpose and Service User Guide also provided information relating to the homes complaints procedure. The Commission for Social Care Inspection have received concerns from a relative, within the last twelve months about the lack of staff provided during the nights, to provide continued care and support to people living in the home. Enquires undertaken by the Commission for social Care Inspection, identified that the home was in breach of the Care Homes Regulations. We also received concerns from Social Services in relation to the level of care provided to one person who had previously lived at the home. This concern was investigated under the safeguarding procedure by Social Services. Discussions with the Registered Provider confirmed that the home did not have a safeguarding policy and it was evident that there was a lack of understanding regarding the correct protocol to follow in the event or suspicion of abuse. The homes recruitment procedure identified that there were no criteria with reference to the suitability of people selected to work within the home. There were also insufficient references in place. Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 18 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, 20, 25 and 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The layout and design of the property was suitable to meet the needs of people accessing the service. Insufficient systems and practices failed to ensure the health, safety and welfare of people using the service. EVIDENCE: Riverview is located in Stoke On Trent, Staffordshire, the two-storey property is situated in a rural area with picturesque views, eight single occupancy bedrooms were provided on the ground and first floor level, six of which were equipped with en suite facility. Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 19 Bathrooms/toilets were provided on both floors, the inspection of the ground floor bathroom identified that the toilet seat was broken and not secured to the toilet, which posed a risk of people sustaining an injury. People were able to lock their bedroom door whilst they were in their rooms; the locking device was not designed to enable the individual to lock their door when they vacated their bedroom. To promote the privacy and dignity of people living in the home, it remains a recommendation that systems in the home should be reviewed to promote the privacy of people. The previous inspection visit to the home identified a requirement for a restrictor to be fitted to a bedroom window located on the first floor, it is of concern that this had been addressed to ensure the safety of the person occupying this room. The Registered Provider has also failed to comply with a previous requirement to ensure that the radiator located in a bedroom is guarded to protect the individual from the hot surface. The home also consisted of a lounge/dining area located on the ground floor, equipped with essential furnishings and fitments to provide a comfortable area for relaxation. A kitchen and a separate laundry were also in place. Appropriate sluicing facilities were provided. There was very little emphasis focused on health and safety, water distribution temperatures accessible to people living in the home was very hot to the touch. There was no evidence that water temperatures were monitored to ensure an ambient temperature of 42 degrees. People living in the home had access to a well-maintained garden. The cleanliness and hygiene within the home was of a high standard. Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 20 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 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People’s general welfare and safety was not guaranteed by having an unskilled workforce. Poor recruitment procedures and practices left people at risk of potential abuse. EVIDENCE: Previous inspection visits to home raise concerns regarding the staffing levels, to ensure that people living in the home were provided with sufficient supervision and support. The examination of the homes working rotas failed to provide clear information relating to staff working patterns. Information contained on the rota did not Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 21 correspond with information in the signing in book. A sample or rotas that were examined failed to confirm that night staff was being provided at all times. The Registered Provider informed us that seven Care Assistants were employed within the home; one person had achieved the National Vocational Qualification Level 2 in Care. It was clear that there was a failure to ensure that a qualified competent person was left in charge of the home at all times. The Registered Provider also confirmed that not all the staff had received relevant training pertaining to their roles and responsibilities such as First Aid training. Riverview Residential Home provided a service for people suffering with dementia, records evidenced that some staff had received training in dementia awareness, there was also evidence that some staff had received moving and handling and food hygiene training. One member of staff informed us, “There is a better relationship with the new owner and she is supportive.” She said, “I don’t have formal supervision sessions.” “I have some training booked but I am not sure what it is for.” She confirmed that she had been in post for a year and had not undertaken moving and handling training but had recently funded the training herself. Discussions with the Registered Provider and the examination of records pertaining to people working in the home raised concerns that there were no criteria regarding the suitability of people employed within the home. There was no evidence of a risk assessment or close supervision provided to an individual who had a criminal conviction and a caution within the last twelve months. There was a lack of consistency in ensuring that two written references were obtained and also the quality of the reference prior to the appointment of staff. The examination of one reference contained information relating to two different people, of which raises concerns to whether the document was genuine. There was no evidence that staff received any form of supervision. Records evidenced that one staff meeting had taken place on 07 January 2008, since the registration of the new Provider in August 2007. Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 22 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, 32, 33, 35, 36 37 and 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The absence of a management structure had a negative impact on the service delivery, failing to ensure peoples rights, welfare and to protect them from abuse. EVIDENCE: Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 23 The home continues to operate without a Registered Manager; there was no management structure in place to ensure the quality of the service delivery, or the health, safety and welfare of people living in the home. The Registered Provider informed us that she was currently overseeing the management of the home. The Registered Provider was undertaking the National Vocation Qualification Level 4. Discussions with her identified that she did not acquire sufficient management experience and had a lack of understanding of the National Minimum Standards and the Care Homes Regulations. Due to the poor outcomes for people living in the home, immediate requirements were issued on the day of the inspection, followed by an urgent action letter, relating to the lack of qualified and competent staff, poor recruitment practices, poor accounting of peoples finances held in safe keeping and the homes medication system and practices. The home will be subject to a Management Review, this is where we liaise with the Regional Enforcement Team regarding what course of action is required to address the concerns identified within the contents of this report. Discussions with the Registered Provider confirmed that a small amount of cash was held in safe keeping for people living in the home. Three records and funds were randomly selected for examination, one record identified that there was £20.00p more than what was actually in safekeeping. The Registered Provider removed this and informed us, that it belonged to her. It is of concern that the Registered Provider maintains her finances with those of people living in the home. There was no evidence that staff members received any formal supervision. With reference to systems and practices that promote the health, safety and welfare of people accessing the service, there was a lack of emphasis focused on safe working practices with regards to medication, or to ensure that Control of Substance Hazardous to Health (COSHH) are maintained securely. Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 24 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 2 X 2 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 1 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 2 2 X X X X 2 3 STAFFING Standard No Score 27 1 28 1 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 1 X 1 1 1 1 Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 25 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. Standard OP7 Regulation 12(1)(a)( b) and 13(1)(b) Requirement One care plan identified a person suffering with memory loss with no clear clinical diagnosis, to ensure that they were provided with the relevant support and care to promote their physical and mental health. Timescale for action 30/05/08 2. OP7 15(2)(b) The registered person should take the necessary actions to ensure that this individual has access to the relevant healthcare professionals regarding an assessment. 30/05/08 There was a lack of consistency in reviewing care plans, to reflect the changing needs of people living in the home, to ensure that they received the necessary support and guidance to live a lifestyle of their choice. The registered person should take the appropriate measures to ensure that care plans provide up to date and accurate information. (This requirement remains outstanding from 30/12/07 and Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 26 3. OP8 will be included within the management review). 13(4)(b)(c Risk assessments provided very ) little information and were not reviewed to reflect the changing needs of the individual. The registered person should take the appropriate measures, to ensure that risk assessments, provide a basis to promote the safety and welfare of people accessing the service. (This requirement remains outstanding from 30/12/07 and will be included within the management review). The risk assessment relating to an individual who selfadministered their medicines was not robust to ensure the safety of the identified person. The registered person should ensure that staff are provided with sufficient information, to enable them to assist the individual where necessary, to promote their independence and safety. (This requirement remains outstanding from 30/12/07 and will be included within the management review). (An immediate requirement was issued on the day of the inspection, timescale 01/03/08). PRN ‘when required’ medicines were in use; there was no protocol in place for the use of these medicines. The registered person should take the necessary action to ensure that people receive their medication as identified by the 30/05/08 4. OP9 13(2) 01/03/08 5. OP9 13(2) 01/03/08 Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 27 General Practitioner, to promote peoples general health. (An immediate requirement was issued on the day of the inspection, timescale 01/03/08). Eyes drops were not dated when opened to ensure that they were disposed of within 28 days as identified on the container. The registered person should ensure that the homes medication system is reviewed to guarantee the safety of people receiving medicines. (An immediate requirement was issued on the day of the inspection, timescale 01/03/08). Medication were not stored in the original box, hence failed to identify who the medicine had been prescribed to, the dosage and intervals. The registered person should take the necessary measures to ensure that medicines are stored appropriately to promote the health and safety of people receiving assistance with their medicines. (An immediate requirement was issued on the day of the inspection, timescale 01/03/08). The medication administration record identified that one person was not receiving the stated dosage. The registered person should ensure that any changes made to people’s medication by the General Practitioner are recorded, to ensure the safety and welfare of the individual. Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 28 6. OP9 13(2) 01/03/08 7. OP9 13(2) 01/03/08 8. OP9 13(2) 01/03/08 9. OP18 13(6) (An immediate requirement was issued on the day of the inspection, timescale 01/03/08). The home did not have a safeguarding policy, discussions with the registered person also identified that she had a lack of understanding of adult protection. The registered person should ensure that people accessing the service are protected from abuse with regards to the homes procedures and practices. A bedroom window located on the first floor was not fitted with a restrictor, to ensure the safety of the person occupying the bedroom. A radiator located within a bedroom was not fitted with a guard to protect the individual from the hot surface. The registered person should ensure that systems are in place to maintain the health and safety of people living in the home. (This requirement remains outstanding from 23/12/07 and will be included within the management review). The toilet seat was broken and not secured to the toilet, which posed a risk of people sustaining an injury. The registered person must ensure that the necessary measures are taken to ensure the safety of people living in the home. 30/05/08 10. OP19 13(4)(a) 30/05/08 11. OP21 13(4)(a) 30/05/08 12. OP25 13(4)(a) Water distribution temperatures DS0000070051.V357395.R01.S.doc 30/05/08 Page 29 Riverview Residential Home Version 5.2 accessible to people living in the home was very hot to the touch. The registered person should ensure that this is addressed to guarantee an ambient temperature of 43 degrees, to promote the health and safety of people living in the home. The home was unable to 23/02/08 evidence that people left in charge were suitably qualified, to ensure the welfare and safety of people accessing the service. The registered person should take the necessary actions to make sure that a qualified and competent member of staff is left in charge at all times, to ensure the safety of people living in the home. (An immediate requirement was issued on the day of the inspection, timescale 23/02/08). 14. OP29 19 and Schedule 2 The examination of files pertaining to staff working in the home identified the absence of references and an application form. The registered person should ensure that the homes recruitment procedure protects people living in the home from abuse. (This requirement remains outstanding from 01/12/07 and will be included within the management review). 15. OP29 Schedule 2 There were no set criteria regarding the suitability of people recruited within the home. The registered person must take Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 30 13. OP27 18(1)(a) 30/05/08 01/03/08 the necessary actions to ensure that people living in the home are protected from abuse. (An immediate requirement was issued on the day of the inspection, timescale 01/03/08). One out of seven staff employed within the home had obtained the National Vocational Qualification and there was very little evidence that people were provided with relevant training pertaining to their roles and responsibility. 16. OP30 18(1)(a) 29/06/08 17. OP31 8 The registered person must take the appropriate actions to ensure that staff are appropriately trained/skilled, to undertaken their roles effectively to guarantee that people living in the home receive the appropriate service. There was no registered 30/05/08 manager in post. The registered provider should take the necessary actions to ensure that a person is appointed to manage the home, to ensure the health, safety and welfare of people accessing the service. There was a lack of evidence to demonstrate that peoples care needs were being met appropriately. The failure to ensure that staffing is provided on a 24-hour basis, left people at risk. The registered person should take the appropriate measures to ensure compliance with the Care Homes Regulations and Care Standard Act 2000. 18. OP32 21(1) 30/05/08 Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 31 19. OP35 Schedule 4(9)(a)(b) (The home was unable to demonstrate that night staff were being provided at all times). (This requirement remains outstanding from 30/11/07 and will be included within the management review). The homes system and practices with regards to people’s finances was not robust to protect people from abuse. The registered person should take the appropriate action, to ensure that people who access the service who require assistance with their financial affairs are protected from abuse. (An immediate requirement was issued on the day of the inspection, timescale 01/03/08). 01/03/08 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. Refer to Standard OP1 OP1 OP1 Good Practice Recommendations To ensure that the homes Statement of Purpose includes information relating to the respite service provided within the home. To ensure that the homes Statement of Purpose is accessible to people living in the home. To ensure that people wishing to access the service are appropriately assessed, consideration should be given in developing and implementing an assessment tool and an admission procedure. The registered person should ensure that consent is obtained from people whose photographs have been used in the homes brochure. People living in the home should be encouraged to DS0000070051.V357395.R01.S.doc Version 5.2 Page 32 4. 5. OP1 OP7 Riverview Residential Home 6. 7. OP8 OP10 8. OP12 9. 10. OP14 OP15 participate in the development and review of their care plan and risk assessment where possible. The registered person should ensure that people living in the home have access to a continent advisor where necessary. The registered person should review systems in operation that promotes the individual’s privacy and dignity, for example, to ensure that the locking device on the bathroom door is working effectively and to ensure that an appropriate locking device as recommended by the Fire Safety Officer is fitted to bedroom doors. After consultation with people living in the home, the registered person should ensure that people are provided with the necessary support and assistance to pursue their chosen social interests. To promote social inclusion, equality and diversity, consideration should be given in providing regular meetings with people accessing the service. A person with visual impairment was not provided with the necessary support and assistance during mealtimes. The registered person should take the appropriate actions to ensure that this identified individual is provided with the adequate level of support to ensure their general health and dignity. Consideration should be given with regards to the format of the homes complaint procedure with reference to people who have a sensory impairment. The registered person should also ensure that all people living in the home are in receipt of a copy of the complaint procedure. To ensure that all staff members receive formal supervision sessions. 11. OP16 12. OP36 Riverview Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 33 Commission for Social Care Inspection 1st Floor Chapter House South Abbey Lawn Abbey Foregate Shrewsbury SY2 5DE 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 Residential Home DS0000070051.V357395.R01.S.doc Version 5.2 Page 34 - 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. 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