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Inspection on 30/01/07 for Rydal Mount

Also see our care home review for Rydal Mount for more information

This inspection was carried out on 30th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

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

Detailed documentation is available about the services and care provided. Positive steps are taken to make these appropriately accessible to people. The manager and staff have the best interests of people in mind throughout their work. Are keen to improve means of interpersonal communication and enhance the lives of people in the home. The manager and staff seek the views, advice and skills of other related professional personnel to achieve this. There is a robust recruitment policy in place. Staff training and development programmes are comprehensive and kept up-to-date. The manager and staff work very hard to maintain a comfortable home for people and do so with the views and wishes of service users.

What has improved since the last inspection?

There is very clear evidence that the manager and her staff continue to provide and improve the services and care provided in a very proactive and inclusive manner. The provision of new and specialised bathing facilities is a great improvement and service users greatly approve and appreciate this.

What the care home could do better:

Develop the service Quality Assurance system so that service users and staff`s views and opinions are sought, acted upon and fully integrated into the overall provision. Continue to develop the use of symbols and graphics for service user information and documentation.

CARE HOME ADULTS 18-65 Rydal Mount Station Hill Wigton Cumbria CA7 9BJ Lead Inspector Cath Wilson Unannounced Inspection 30th January 2007 11:00 Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 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 Rydal Mount DS0000022577.V319672.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 Adults 18-65. 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 Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rydal Mount Address Station Hill Wigton Cumbria CA7 9BJ 016973 49266 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) www.c-i-c.co.uk. Community Integrated Care Mrs Janice Coates Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 2006 Brief Description of the Service: Rydal Mount provides the services and care for four people with a learning disability and is operated by Community Integrated Care. Rydal Mount is a detached bungalow set in its own grounds on the outskirts of Wigton. The home is near to the local services and facilities. The gradient of the home’s driveway necessitates the use of the home’s transport when service users want to leave the grounds. There is a large accessible patio area with seating, to the rear. Inside the home there is a large lounge/dining room and a smaller lounge. As well as four single occupancy private bedrooms there is a kitchen and utility room. Specially adapted bathing and toilet facilities are fully accessible. Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection to the home that was undertaken during the morning period. During this visit I was able to meet residents, the registered manager and staff. Relatives of service users and health care personnel had completed comment cards regarding the provision of care. The registered manager had completed a pre-inspection questionnaire prior to this visit. This assisted me in verifying information throughout the inspection. A tour of the premises was undertaken. Staff, resident’s records and administration files were assessed. What the service does well: What has improved since the last inspection? There is very clear evidence that the manager and her staff continue to provide and improve the services and care provided in a very proactive and inclusive Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 6 manner. The provision of new and specialised bathing facilities is a great improvement and service users greatly approve and appreciate this. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good procedures and paperwork in place to ensure appropriate referrals and that they accept people whose needs they can meet. EVIDENCE: The information available to prospective residents, their family or representatives is well documented. The manager is fully informed of the criteria for needs led assessments and incorporates this information comprehensively into individual plans of care. People are able to visit the home prior to admission and this is achieved with the existing resident’s needs taken into consideration. People are provided with choice and being provided with opportunities to visit the home allows an informed and supported decision to be made. The Statement of Purpose and Service User Guide are regularly reviewed and currently being updated. Both documents are accessible and available to family and representatives also. The home’s use of photographic and symbols in their documentation is being developed. This further involves residents in everyday events in their life and positively includes them in this. Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 and 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager and staff are very focussed on achieving the individual outcomes for people. This is carefully monitored through a developed system of care planning. Risk taking is well managed and a good balance is achieved between promoting independence and ensuring the well-being and safety of people in the home. EVIDENCE: The key principles of the home for delivering a quality service are based on the belief that people in the home are supported to lead individual lifestyles. Staff are strongly committed to supporting all residents to make informed decisions, understand the range of options that are available to them and that they have the right to take responsible risks. The resident plan is developed in partnership with the resident, based on an efficient assessment. The plan clearly sets out how specialist requirements will be met through positive and planned interventions. Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 10 Residents are well supported through individually tailored support plans that promote positive interactions and experiences. Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s rights are very much promoted and their individuality respected. Meal times are also catered for on an individual basis both in the home and through using community facilities. EVIDENCE: People’s leisure and community involvement is detailed in their records and staff are supportive in people attending these. Staff attend these in a manner that respected people’s individuality and planned people’s inclusion with this in mind. Staff who met with me displayed a great interest and enthusiasm in encouraging people to have meaningful and enjoyable experiences. Seeking opportunities to further people’s choice and participation in everyday events. Family members are encouraged to have involvement. Mealtimes are arranged to meet individual need whether this be in the home or community. Staff Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 12 encouraged people to make their own decisions and their rights and choice are recognised and promoted. It is clear that this is one of the underpinning values of Rydal Mount. Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health care matters are well managed and documented. Medicines management is good. EVIDENCE: Staff are very knowledgeable of peoples needs including their health care arrangements. The staff team work very positively with the local health care professionals to offer a responsive and supportive approach in assisting people to maintain and receive the right attention. Specialist assistance and guidance is incorporated into the home’s approach and practices and actions regularly reviewed. Training has been provided to staff regarding medicines management in the home and this is under review. The records assessed at this inspection were generally well detailed. Policies and procedures for medicines handling are in place and are appropriate for the home. Records indicate there is much work being achieved in supporting people in their health care needs and individuality is sensitively attended to ensure people’s dignity is upheld. Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s complaints system is available to both service users and their family and arrangements for safeguarding vulnerable adults well managed managed. EVIDENCE: There is a complaints procedure in place and this information is being developed so that it can be more accessible to service users using more appropriate formatting. Matters relating to the safeguarding of people are an integral part of the staff training programme and arrangements in place to keep up to date with this. Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from living in a comfortable environment that is well maintained and safe. EVIDENCE: Arrangements are in place for the health and safety of people in the home and for their environment. Guidelines are followed and records are kept up-to-date regarding environmental health and fire safety. Specialist equipment is regularly serviced and the home had access to advice and guidance regarding environmental matters. Each resident has their own bedroom and arrangements are in place to upgrade and replace furnishings and décor when needed. People in the home and staff work together to provide a very comfortable, pleasant and well-maintained environment and one they feel very proud of. The outside garden area is also very well maintained and this was being attended to at the time of my visit. Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are very motivated and committed to meeting the comprehensive needs of people in the home. EVIDENCE: Staff are provided with a good training and development programme and the manager and senior staff are pursuing additional training issues so that they can enhance the lives of people in the home. There is a high percentage of staff that has NVQ qualifications. The staff I met during the inspection are well informed of the needs of people and certainly have great commitment to placing their needs first and provide them with life enhancing experiences. New staff to the home had had a clear induction period into the home and they are appropriately supervised during this. Their training needs are identified and they are supported and encouraged in their work. There was an enthusiasm present in this staff group that is encouraging and they showed imaginative ways to further include service users in the decision making process. Looking at ways to make information user-friendly and more accessible is an ongoing process for them but these are all examples of good care practices. The home follows the recruitment procedures of Community Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 17 Integrated Care. Staff had all the appropriate checks and references completed prior to taking up their post and all appointments are subject to a probationary period. Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40 41 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from a service that places their personal needs first and where they are valued as individuals. EVIDENCE: There are good systems in place that attend to and support the comprehensive needs of service users. Staff are very focussed on meeting the needs of people and to seeking ways to enhance their lives. Community Integrated Care monitors the delivery of services and care and their operations manager carries out quality assurance checks on regular unannounced visits to the home. The Commission for Social Care Inspection is notified of the outcome of these visits. The registered manager also informs the Commission for Social Care Inspection of important events that happen in the home. The home are Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 19 developing and strengthening their methods of Quality Assurance. General health and safety matters are attended to. The records examined on the day of the inspection were well ordered and confidentially stored. Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 3 4 4 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 4 33 4 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 X 4 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 3 3 3 X Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 21 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Rydal Mount DS0000022577.V319672.R01.S.doc Version 5.2 Page 23 - 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!