Inspection on 18/08/05 for Rydal Road Care Home

This inspection was carried out on 18th August 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.

Other inspections for this house

Rydal Road Care Home 01/04/09

Rydal Road Care Home 22/01/08

Rydal Road Care Home 28/02/07

Rydal Road Care Home 23/05/06

Rydal Road Care Home 09/12/05

Rydal Road Care Home 11/01/05

Rydal Road Care Home 09/06/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Rydal Road Care Home Rydal Road Darlington DL1 4BH Lead Inspector Debbie White Bill Drumm Unannounced Inspection 18 August 2005 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 Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rydal Road Care Home Address Rydal Road Darlington DL1 4BH 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) 01325 369329 01325 369339 Tamaris Healthcare (England) Limited (wholly owned subsidiary of Four Seasons) Care Home 60 Category(ies) of Dementia - over 65 years of age (38), registration, with number Old age, not falling within any other category of places (22), Physical disability (6), Terminally ill (4) Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 11 January 2005 Brief Description of the Service: Rydal Road Care Home is situated on the outskirts of Darlington town centre and is within easy reach of shops, leisure facilities and a local park. Frequent bus services operate within a short walking distance of the home. The home is divided into two separate units. The general unit provides nursing and residential care for older people, and the second unit provides 24 hour nursing care for older people suffering from dementia. Residents at the home all have single bedrooms with en-suite facilities. The home provides a variety of communal lounges and dining facilities. There is also a large garden area at the home for residents. Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and lasted one day. Two inspectors visited the home and spoke with a number of service users, the staff on duty, and one visitor who was at the home at the time of the inspection. The temporary manager was available throughout the afternoon to help the inspectors, and she was given verbal feedback about the issues raised during the visit. Other ways the inspectors looked at the home included: • • • • • • • • • Talking with the service users and staff Talking with the temporary manager of the home Reading the service user’s files Reading the staff files Looking at policies and procedures Watching the staff and service users together Looking around the home Talking to a visitor at the home Observing the staff and service users during a meal As this inspection visit was unannounced, there were no pre-inspection questionnaires sent to service users, their families or placing social workers before the visit. However, a number of forms were left at the home for the manager to give to people who live at the home and to send to the families and placing authorities so they could send their views about what it is like to live at the home. At the time of writing this report, no questionnaires have been returned to the Commission. In line with current CSCI policy on ‘Proportionality’, the inspection focused upon a number of core standard outcomes for older people. The core standard outcomes not inspected on this occasion will be assessed during the next inspection. What the service does well: This home are good at offering residents a range of activities, and the staff are fully supportive of the need for older people to be engaged in pursuing their interests. Although there were some issues raised regarding how some residents were treated by the staff with regard to privacy and dignity, generally the staff on duty appeared to be committed in caring for the residents living at the home. A visitor who spoke to one of the inspectors praised the staff saying ‘they work really hard, and they do their best. I am happy with the care’. The domestic staff were praised at the standard of cleanliness at the home, despite having some problems with staffing levels. All Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 6 the staff spoken to, including the temporary manager fully co-operated with this inspection, and appeared motivated to improve the services at the home. Residents spoken to during this visit commented that ‘the girls are lovely, they look after us’ and ‘it’s alright here, the staff are caring’. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 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 Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 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) None of these outcomes/standards were assessed on this occasion. They will be examined during the next inspection of the home. EVIDENCE: Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 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, 10. The home could improve how the resident’s assessed needs are set out within individual care plans, and care must be taken to date and sign any documents relating to managing individual care needs. Care-plans and risk assessments must be reviewed regularly, and the staff working at the home need to do better in reading the resident’s files and applying any nursing care interventions identified. The home could do better at ensuring the health needs of service users are met. The home is generally good at offering personal support in such a way as to promote and protect resident’s privacy, dignity and independence. However, the staff need to further develop skills in promoting dignity and respect in older people who need additional help and support. EVIDENCE: A number of resident’s files were looked at as part of this inspection. Some of the files were well written, and contained the required information as identified in the National Minimum Standards for Older People, but some issues were raised as to the quality of some of the recording. Each resident has their own individual care-plan, which provides information for staff in relation to their Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 10 health, personal and social care needs. An inspection of resident’s files showed some gaps in recording (missing signatures of the named nurse), and in some of the files there was no dates entered on assessment information to ensure that all care-plans and risk assessments are reviewed regularly. One file inspected showed that although it was documented that the care-plan had been evaluated monthly, the information in the care-plans and risk assessments had not changed for over a year. None of the files had a photograph of the resident in place to enable staff not familiar with working at the home to clearly identify each resident. Some assessment data (such as nutritional assessments) identified residents as being a ‘high risk’, but the associated care-plans were not clear about how the staff were to reduce any risks identified with significant weight loss. There was no evidence of service user involvement in the care-plans, nor that of any family involvement – apart from signatures for the use of cot-sides. The risk assessments relating to prevention of falls were inadequate, and the intervention to prevent falls in the elderly was raised as an issue. The registered nurses spoken to during this visit expressed concerns about not being allocated any time to ensure careplans and risk assessments are up to date, and the support workers consulted said ‘we rarely read the care-plans, we don’t have the time’, and ‘we depend on staff handovers to hear about the resident’s. We do talk among ourselves about what has happened, but we don’t look at the care-plans’. The records inspected relating to the prevention of pressure sores was inspected. Care-plans were in place for the prevention of pressure sores, and there was evidence that residents at the home with pressure sores are monitored in part. The staff on duty were asked about the provision of equipment and reported that they had concerns about the lack of medical equipment in the home. One nurse said ‘we try to get medical equipment for the residents but we never seem to get what we need. It has improved a bit, and we have been told we will get things, but it’s a struggle sometimes’. One resident was being nursed in bed at the time of this visit and although it was noted that she had a pressure mattress in place, there was no evidence of any staff intervention such as pressure relief, fluid balance charts, or dietary intake. There was some evidence in the resident’s files that nurses undertake a ‘mental health assessment’, but there was no evidence that any restorative or preventative work is undertaken. Some of the records of residents having access to hearing, sight tests and appropriate aids were incomplete. The residents spoken to who live on one ‘unit’ of the home said they felt that all staff members treat them with dignity and respect. A positive rapport was observed between the residents and the staff on duty. Two residents spoken to during the inspection commented that “the people are nice” and “they do their best”. Another resident said, “there aren’t enough staff”. Some of the observations made by the inspectors during this visit caused concern with regard to promoting privacy and dignity in the home, including staff members openly discussing residents needing assistance to go to the toilet. Another incident occurred where the inspector observed one resident throwing a cup of Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 11 coffee over another resident in the morning. The staff intervened and ensured the resident wasn’t hurt, and the inspector moved to another part of the home to continue the inspection. When the inspector returned later in the day, it was noted that the resident was still wearing the same clothes covered in dry coffee stains. The inspector spoke with the resident and she said ‘I’m sorry about my clothes, I look at mess, I need to change, someone threw coffee on me’. Other observations included residents wearing clothes covered with food stains, residents wearing tights/stockings with holes in, and slippers that didn’t fit and were badly stained. Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15. The home are good at offering residents the opportunity to participate in a range of organised recreational activities, which helps to keep them active and prevent boredom. Residents are enabled to maintain contact with family members and friends, and visitors are encouraged to come to the home at any reasonable time. The home needs to improve the arrangements to ensure residents receive an appealing well balanced diet in pleasing surroundings at times convenient to them. EVIDENCE: The home has its own activities co-ordinator who is responsible for organising a range of activities within the home. Staff members spoken to at the time of the inspection showed a willingness to help facilitate and support activities for residents, however they went on to say that due to work pressures they rarely had the opportunity to become involved in this area of work. Discussions with residents and staff confirmed that visiting times are flexible and visitors are welcomed at any reasonable times. During the period of inspection a number of visitors were observed to visit relatives and a good rapport was seen to exist between themselves and staff members. Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 13 The home has recently appointed a new chef who was positive about his role and the need to provide service users with “good food”. Some of the service users spoken to were happy with the food provided, and described it as “alright”. The residents consulted also confirmed that portion sizes were sufficient to meet their individual needs. A study of the menus showed that a choice of meals is available, but staff comments about the meals at the home seemed to suggest that a greater choice of meals is needed to meet the needs of some of the residents. The inspector observed a meal taken, and noted some areas in need of improvement. The staff were noted to be very busy and hurried whilst assisting the residents to have their lunch. There were a number of residents having the meal, and although the majority needed help in some way, there were only four staff members available to assist. One service user was noted to be having some difficulty eating her lunch, and pushing her food off the plate. The inspector asked a member of staff if there was a ‘plate guard’ available for the lady, and the staff member said she didn’t know. The staff member did not appear to think this was an issue, and did not attempt to provide a ‘guard’ for the lady. Another member of staff did intervene and provided the equipment to ensure the resident could eat her meal. Many of the residents taking the meal were observed to be struggling to eat the meal provided which resulted in them eating their ‘hot’ meal cold and congealed. On the day of inspection the weather was very sunny resulting in the temperature in the home being very warm, and the atmosphere humid and uncomfortable (there were no room thermometers to check the exact temperature). The residents were observed to be notably hot, yet no fluids (for example cold water or juice) were seen to be available for the more able residents should they be thirsty, nor was it observed that the less able residents were offered additional cold drinks. Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16. The home need to evidence that residents, their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. EVIDENCE: At the time of this inspection the Commission had received a complaint from a relative of a resident living at the home. As this complaint is outstanding, issues around complaints were discussed with two senior staff members on duty and the temporary manager. The staff informed the inspector that staff from ‘Darlington Social Services Department’ had recently visited the home in relation to a complaint, and they were aware that the providers of the home were doing an internal investigation into the matters raised. The staff on duty felt that relatives and residents complaints are taken seriously by the staff at the home, and commented ‘the relatives come to me, and will talk about any problems. We try to do what we can’, and, ‘we try to make sure that families are told everything about the residents’. Another staff member said ‘I think we have a good relationship with the residents, but I’m not sure about any complaints being investigated at the minute. Senior managers would do that sort of thing’. The matter of complaints was discussed with regard to complaints being made to external agencies as oppose to using the home’s complaint procedures. The temporary manager assured the inspectors that all complaints are taken seriously, and that all the issues raised would be fully investigated by the providers of the home. It was agreed that following the outcomes of any outstanding complaints, this standard would be fully assessed at the next inspection visit. Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 15 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, 21, 22, 23, 24, 25 and 26. Residents live in a safe, well-maintained environment, although the kitchen area has a number of areas where refurbishment is necessary. The home provides residents with access to safe and comfortable indoor and outdoor facilities. The home provides single bedrooms with en-suite facilities, and there are sufficient additional bathing/toilet facilities to meet the resident’s needs. The residents do not have sufficient specialist equipment in order to maximise their independence. Resident’s bedrooms are designed, decorated and equipped to suit their needs. The home generally provides safe, comfortable bedrooms where residents can keep their own possessions, but not all residents have the facility to lock their private accommodation (bedrooms) to ensure security and privacy. Residents’ live in safe comfortable surroundings. Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 16 The home is reasonably clean, pleasant and hygienic. EVIDENCE: An environmental inspection of the home was undertaken and all areas of the building were found to be in a good state of repair. The kitchen area of the home was noted to be generally acceptable, but a number of repairs were observed as necessary; including the “fly screen” between the outside door and kitchen area, and the floor area around the dishwasher which was badly stained and in need of replacement. The grounds of the home were observed to be very pleasant and well maintained. A recent visit to the home by the Environmental Health Department had raised some issues, but the home was found to be dealing with any non-conformity identified. The home provides spacious accommodation, including a number of small lounges to offer residents privacy. The garden area is very pleasant, and there is seating available for residents to enjoy sitting outdoors. A number of resident’s bedrooms were inspected all of which had en-suite toilet and washing facilities. The home provides adequate bathrooms/toilet facilities throughout the building, but it was found that one of the communal toilets was used to store boxes. Resident’s who live at the home have a range of different mobility needs. Staff members spoken to stated that only one electrically powered “stand aid” was available within the building, and therefore problems would be experienced should this item of equipment become inoperable. Additionally, only one person can use the equipment at any one time, which may cause difficulties in a home of this size. It was noted that equipment at the home is stored in bathrooms, and in corridor areas. A discussion was held with two members of staff regarding the provision of specialist medical equipment, and one member of staff commented ‘we can’t get medical equipment that we need. We ask for things, and are told we will get them but they never seem to arrive. I have spoken with the manager and she has assured me this will be looked into, but we’ll just have to see’. The chef also indicated that there were some shortages of equipment in the kitchen, specifically a “date gun” for adequately date marking food items and large dinner plates. A number of bedrooms were inspected and found to meet the individual needs of each resident. The doors of individual bedrooms were fitted with a number of different door locks. Some had a “mortise” type lock, some had a “twist” lock and others had no means of securing the rooms at all. The previous inspection highlighted this as an area that the home must to address, requiring that all bedroom doors Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 17 must be fitted with locks suited to the needs and capabilities of individual residents. Residents live in safe, comfortable surroundings. There was seen to be some furnishings in need of replacement and some carpets in need of cleaning, but the manager was able to demonstrate that these matters are being actively resolved. An environmental inspection showed the home was reasonably clean and tidy. One of the issues raised by the staff during this visit was a shortfall in cleaning hours to meet the needs of the residents, and problems with sickness and absence of cleaning staff. A study of the ancillary duty rota showed there are 11.5 cleaning hours allocated Monday to Friday, and 7.5 hours Saturday and Sunday. The inspector questioned this level of domestic hours for the size of the home (60 bedrooms plus communal areas). Additional laundry hours are allocated at 7.5 hours Monday to Friday, and 4.5 hours Saturday and Sunday, and again the present provision was questioned as being adequate to meet the needs of the home. It was pleasing to note that despite the size of the home, and issues around the management of continence, the home was mostly free from offensive odours. Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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, 29. The inspectors were not satisfied that the staffing levels at the home are adequate, and the home need to evidence that the skill mix of the qualified/unqualified staff are appropriate to the assessed needs of the residents, the size and layout of the home, and the home’s purpose and function. The arrangements for the recruitment of staff are adequate, but the home must ensure that there is written evidence within the staff files that all the required checks have been undertaken. EVIDENCE: Throughout this inspection visit, it was observed that the staff on duty were very busy attending to the needs of the residents living at the home. The staffing levels for the ‘EMI’ unit at the home were inspected, and staff were consulted about how they felt they were able to meet the needs of each individual resident. The residents in this unit are nursed on two floors, with staff being allocated to work on a specific floor for the duration of their shift. On occasion there is a ‘spare’ member of staff to work between the two floors. Each floor had 18 residents at the time of the visit, and the staffing levels were 1 qualified nurse, and 2 support workers for each floor. The staffing levels for a night duty are 1 qualified nurse, and 3 support workers (2 staff members per floor). All the staff spoken to on the day of the inspection felt that they did not have enough time to adequately care for the residents. Problem times were identified as mornings when the qualified member of staff had to deal with the unit’s administration, leaving two support workers to assist 18 high Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 19 dependency residents and maintain safe observation levels. Meal times were also raised as a very busy time due to the high number of residents needing help and assistance to take an adequate diet, and the qualified nurse having to administer medication. Night times were also highlighted as causing concern as staffing levels were reduced to two staff members for each floor. It was noted that the qualified staff members are counted in with the staffing levels provided to deliver ‘direct care’ to the residents, and are not allocated any additional time to attend to their nursing duties with regard to the written documentation required to ensure that residents are receiving evidenced based nursing care. Staffing issues were discussed in full with the temporary manager at the time of this visit. The staff consulted also raised issues about staff ‘morale’ at the home being very low, and a resident spoken to said ‘the staff are nice, but they are always so busy. There are not enough staff here’. An examination of a random number of staff files evidenced that the home has adequate recruitment procedures. Of the files inspected, there were two references in place, and evidence that staff had been interviewed. It was noted at the time of the inspection that one staff file did not have any evidence that CRB check had been undertaken. This was raised with the temporary manager at the time of the inspection, and the inspectors were assured that all staff employed at the home had undergone CRB checks, and the lack of documentation in the file would be addressed immediately. Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 31, 35, 36. At the time of this inspection, the home did not have a registered manager. Robust procedures for the safekeeping of residents’ money are in place. The staff at the home are not receiving regular staff supervision. EVIDENCE: At the time of this inspection, the home did not have a full time registered manager in post, however, the providers had made interim arrangements for a registered manager from another home in the group to oversee the home (for three days per week) until a replacement manager has been recruited. The home has comprehensive policies and procedures in place for dealing with resident’s finances. Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 21 A study of the staff supervision records evidenced that supervision is not taking place with each staff member at least 6 times a year. A senior member of staff consulted about staff supervision said ‘we are not doing supervision as we should due to being short staffed, and really busy’. Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 3 3 3 2 3 2 3 3 STAFFING Standard No Score 27 2 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 x x x 3 2 x x Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 23 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 7 Regulation 14 & 15 Requirement The registered person must ensure that the needs of service users have been assessed by a fully qualified person, and there has been appropriate consultation regarding the assessment with the service user, or a representative of the service user (this requirement was due to be actioned by 11.01.05) The registered person must ensure that the home is conducted so as to promote and make proper provision for the health and welfare of service users. The registered person must ensure that service users are treated with dignity and respect. The registered person must ensure that service users receive a varied, appealing, wholesome and nutritious diet. Mealtimes must be unhurried and staff should be available to offer assistance where required. The registered person must ensure that service users have the specialist equipment thay require to maximise Timescale for action 30.09.05 2. 8 12 30.09.05 3. 4. 10 15 12 16 30.09.05 30.09.05 5. 22 22 31.10.05 Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 24 indepenedence. 6. 24 13 & 23 The registered person must ensure that doors to service users private accommodation are fitted with locks suited to the service users capabilities and accessible by staff in emergencies (this requirement was due to be actioned by 11.01.05). The registered person must ensure that, having regard to the size of the care home, the statement of purpose and the number and needs of the service users, suitably qualified, competent and experienced staff in such numbers as are appropriate for the health and welfare of service users. The registered person must not employ a person to work at the care home unless the person is fit. All the information as listed in Schedule 2 must be obtained for all staff employed at the home. The registered provider must employ an individual to manage the care home. The registered person must ensure that persons working in the home are appropriately supervised. 31.10.05 7. 27 18 30.09.05 8. 29 19 30.09.05 9. 10. 32 36 8 18 31.10.05 31.10.05 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 16 Good Practice Recommendations It is strongly recommended that the home reviews how complaints are managed to ensure that service users and their relatives and friends are confident that their B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 25 Rydal Road Care Home 2. 19 complaints will be listened to, taken seriously and acted upon. It is strongly recommended that the environmental issues raised in this report regarding the main kitchen are addressed without delay. Rydal Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection No.1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Road Care Home B54 S746 Rydal Road V243763 180805 Stage 4.doc Version 1.40 Page 27 - 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!