Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 07/06/05 for Rydal House Nursing Home

Also see our care home review for Rydal House Nursing Home for more information

This inspection was carried out on 7th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The care plans identified the service user`s needs, were up to date and evaluated on a monthly basis. The relative or service user had signed the plans to record that they had been consulted on the documentation. Both these actions will assist with the delivery of care and keep the relative / service user aware of the planned intervention. The atmosphere of the home is relaxed, staff are friendly and the services users were satisfied with the care and service provision.

What has improved since the last inspection?

There had been compliance to the requirements raised at the last inspection.

What the care home could do better:

The registered person should provide sufficient food to ensure that service users have a choice of meal. A menu should be displayed to show that a choice is available. The registered person should ensure that the repairs and redecoration are acted upon, prior to an inspection, rather than the issues being raised by the inspector. Cleaning substances should be secured away and window restrictors not immobilised.The registered person should ensure the use of staff to undertake various tasks does not place the service user at risk. The registered person should comply with all requirements within the specified timescale.

CARE HOMES FOR OLDER PEOPLE RYDAL HOUSE 21 SOMERSALL LANE CHESTERFIELD DERBYSHIRE S40 3LA Lead Inspector IVAN BARKER Unannounced Inspection Tuesday 7th June 2005 at 10:00am 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 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. RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Rydal House Nursing Home Address 21 Somersall Lane Chesterfield Derbyshire S42 7LD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr D Chand 01246 569511 Mrs Maureen Brown Care Home with Nursing 31 Category(ies) of OP registration, with number of places RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 13/12/2004 Brief Description of the Service: Rydal House is situated on the western side of Chesterfield within a pleasant residential area, close to local amenities and within easy access of a main bus route. The home is a converted building, with an extension, set in its own grounds and has car-parking facilities.It has separate lounges and dining rooms, on the ground floor. A new conservatory has been added. The home has provision for nursing and personal care, and is registered to provide care for a maximum of 31 residents. RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The person present at the inspection was: Mrs M Brown, manager. Within this inspection, which occurred over a four-hour period, the inspector toured the building, spoke to service users, and staff and examined the care plans and other documentation. He spoke with 8 service users; unfortunately no relatives or visitors were present during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The registered person should provide sufficient food to ensure that service users have a choice of meal. A menu should be displayed to show that a choice is available. The registered person should ensure that the repairs and redecoration are acted upon, prior to an inspection, rather than the issues being raised by the inspector. Cleaning substances should be secured away and window restrictors not immobilised. RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 6 The registered person should ensure the use of staff to undertake various tasks does not place the service user at risk. The registered person should comply with all requirements within the specified timescale. 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. RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 Intermediate care was not provided. EVIDENCE: The manager advised the inspector that the home did not provide intermediate care. RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 Accurate care plans contribute to the delivery of care. EVIDENCE: On examination of 4 care plans the inspector established that the plans identified the service user’s needs, were up to date and evaluated on a monthly basis. The relative or service user had signed the plans to record that they had been consulted on the documentation. RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 The service users, who spoke to the inspector, were satisfied with the quality of their meals. The registered person was unable to evidence that a choice and adequate food provision was available to the service users. EVIDENCE: On discussing the issue of food with the service users, situated in the lounge areas prior to dinner, the inspector received such comments as, ‘The food is excellent, but we don’t know what it is until we are given it.’ On discussing the intended meals for the service user users would had wished to remain in their rooms, the inspector received comments such as; ‘The meals are good, but I have no idea what I am getting until it comes, and for another service user, ‘It’s a surprise’. The inspector discussed the absence of a menu being displayed and the comments received by the inspector, with the manager. She advised that the kitchen ‘over catered’ to ensure that service users had a choice of meal, and that the kitchen staff were aware of service users likes and dislikes. RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 11 The cook was unable to provide any examples of documentation that showed that service users had been consulted or that the food was being cook as requested by the service user. She identified that she provided one main meal, which most people liked and an alternative for those who didn’t like the main meal. On observing the meals being served, the inspector found that the majority of service users had the same meals. However 3 service users in the dining room did have a different meal. On examination of the contents of the 2 freezers, the inspector found that they only contained sufficient food to cover the meals on the kitchen menu, from Tuesday, the day of inspection, up to Friday breakfast. The cook informed the inspector that the ‘proprietor shopped and delivered on a Friday and this was also the ‘meat delivery day’ for the following week’. On examination of the cold store, this did contain some tinned foods particularly tinned tomatoes. The inspector raised his concerns that the home was dependant on the food being delivered on the Friday, and any untoward occurrence i.e. sickness of the proprietor, vehicle breakdown, inclement weather etc could create problems at the home. The inspector concluded that the service users were not offered a choice of meal. This conclusion was supported by the lack of menu showing an alternative, the observations by the inspector, the information received from service users and the minimal stock of food. RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 0 These standards were not assessed, at this inspection. EVIDENCE: RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 26 The environment had not been maintained to the required standard. The service users were being placed at risk, by the lack of controls on the window restrictors and cleaning substances. EVIDENCE: The previous requirements were monitored. The manager informed the inspector that the carpets within Rooms 3 and 15 had been replaced. However the carpet and the other furnishings within Room 34 had been extensively cleaned and the odour was no longer present. The inspector examined this room and found the information to be correct. On touring the building, the inspectors found the following; Within Rooms 16, 23 and 27, there was a need for remedial repair to the walls and some redecoration. RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 14 Within Room 29, there was a strong odour. The manager informed the inspector that the carpet had been cleaned this morning. She agreed to investigate further, and act upon her findings. Within Rooms 23 and 25, the window restrictors had been released, and the windows were open in a wide position. Service users or children could have fallen from these windows. The manager acted promptly and refitted the restrictors. Within Room 8 there had been substantial water damage, caused by a leaking roof, which resulted in the ceiling collapsing, within the corner of the room. The roof, ceiling and walls had been repaired and the areas re-plastered. The room was yet to be decorated. The lady who resided in this room had been relocated to another room. The cupboard storing cleaning solutions was found to be unlocked. No member of staff was found near the unlocked cupboard. Chemicals and other dangerous substances should be locked away, under COSHH regulations. RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28. Current staffing levels in place would appear to meet the current dependency needs of service users, accommodated within the home. However this is dependent on the goodwill of the staff, and their ability to ‘multi-task’. The multiplication of duties will have a detrimental impact on the service users if correct procedures and safeguards are not followed. EVIDENCE: On examination of the duty rotas and discussion with the manager the inspector established the following; Care provision. On the am shifts, there were I qualified nurse and 4 care assistants. On the pm shifts, there were I qualified nurse and 3 care assistants. In addition, a member of staff, who worked 12.30 to 14.00, in the kitchen and 14.00 to 19.00hrs on care / activities. On the night shifts, there were I qualified nurse and 2 care assistants. The rotas also showed that staff undertook ancillary as well as care work. For example: Members of staff worked on housekeeping duties on one day and care the next. Also there were duties were the staff worked on housekeeping or kitchen duties in a morning, and care in the afternoon. RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 16 The inspector raised with the manager his concerns of using staff in such a way and identified that the home should consider issues regarding safe working practices, possible cross contamination and EU working time directives. The manager advised the inspector that her staff were ‘multi – skilled’, aware of the need to change uniforms when undertaking different tasks, and worked the hours that they wished. There was no policy in the home instructing staff on the safe practices required when undertaking multi tasks. The manager identified that she was supposed to be 2 days supernumerary, for purposes of management issues, supervision of staff etc. On examination of a four-week rota, the inspector established that she had been supernumerary for 2 day within a 2 week period and 2 weeks without any supernumerary time. Through the examination of the rotas and discussions with staff and service users the inspector established that the home is operating on a small group of dedicated staff, who are undertaking different tasks to ensure the home provides a service. The staff identified that there were satisfied with the care, but identified that because the total number of staff was not large then it did place a strain on them, particularly when they had to cover for sick leave etc. However they did agree that the home was not left short of staff, as they always agreed to cover the extra shifts. They also identified that it was a small friendly team that communicated well and supported each other. The service users informed the inspector that they were satisfied with the care. However they would like the activities and outings to be increased. This information was relayed to the manager. The inspector will monitor these issues at a further inspection, together with the management issues. RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 0 These standards were not assessed, at this inspection, except for the previous requirement. The self-analysis by the manager should assist the home in identifying area of weakness and shortfall. EVIDENCE: The previous requirement of implementing a quality assurance system was monitored. The manager had started the process by sending out and receiving back questionnaires, and undertaking a basic analysis of the service. RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 2 2 x x x x x 2 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 19 yes Are there any outstanding requirements from the last inspection? 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 15 Regulation 12 and 16 Requirement The registered person must ensure there is adequate provision of food to ensure that service users have the opportunity of a choice of meal The registered person must ensure that the service users are not placed at risk, by the removal of the window restrictors and the non securing of cleaning substances. The registered person must ensure that the service users live in a safe, clean, pleasant, well maintained environment. Therefore rooms 8, 16, 23, 27 and 29 require attention as listed in the body of the report. The registered person must ensure that the service users are not placed at risk, by the use of staff undertaking multiple tasks. A procedure needs to be in place to be able to manager this risk. Timescale for action 7th August 2005 2. 19 12 7th July 2005 3. 20, 26 16 7th September 2005 4. 27, 28 12 7th July 2005 RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 20 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 Good Practice Recommendations RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI RYDAL HOUSE NURSING HOME C52 CO2 S2073 Rydal House V231674 070605 Stage 4.doc Version 1.30 Page 22 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!