Inspection on 22/01/08 for Rydal Road Care Home

This inspection was carried out on 22nd January 2008.

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.

Other inspections for this house

Rydal Road Care Home 01/04/09

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 18/08/05

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 Durham DL1 4BH Lead Inspector Bridgit Stockton Unannounced Inspection 22 January 2008 09:30 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 Rydal Road Care Home DS0000000746.V354419.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. Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rydal Road Care Home Address Rydal Road Darlington Durham DL1 4BH 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) 01325 369329 01325 369339 www.fshc.co.uk Tamaris Healthcare (England) Ltd Position Vacant Care Home 60 Category(ies) of Dementia - over 65 years of age (38), Old age, registration, with number not falling within any other category (22), of places Physical disability (6) Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. NAMED INDIVIDUAL: The home may accommodate a named individual a set out in a letter to the registered person dated 20 July 2006 which establishes the basis on which the individual’s needs will be met by the home. Where necessary the homes statement of purpose shall reflect any changes in service provision required for this arrangement. This condition may not apply to anyone else, other than the named individual, who falls outside the registered category. 28th February 2007 Date of last inspection 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 people to use. Rydal Road Care Home DS0000000746.V354419.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, 1 star. This means the people who use this service experience adequate, quality outcomes. The purpose of this inspection was to assess the quality of the care and support received by the people who live at Rydal Care Home. The methods I used to gather information included a visit to the home, conversations with the people who live there, their relatives, healthcare professionals and the staff. I looked in detail at the care and records of four people, examined other records and looked around the home. I spent four hours at the home. I was also accompanied on this visit by someone called an expert by experience who talked to the people who live at the home about what it is like to live at Rydal Care Home. Some of her finding and observations will also be included in the report. The manager also completed the home’s pre-inspection questionnaire. These questionnaires provide valuable information to help me form a judgement about the quality of service offered at the home. What the service does well: The people we spoke to said they are happy with the care and support they receive. They said that staff were friendly and gave them help and support when they needed it, one person said ‘nothing is a trouble for the girls they are very willing and good at the job’. The pre-admission assessments are thorough and the majority of people said they had sufficient information about the home before choosing to live there. The people who live at the home and their relatives confirmed that they know how to raise a concern or make a complaint, if they needed to. One person said ‘I would tell the staff or the manager if I have a problem’. There are thorough recruitment and selection procedures in place, to make sure that staff are suitable and safe to work with the people who live at the home. All the staff receive a range of training to equip them with the skills and knowledge they need to do their work. Several members of nursing staff were attending some training on the day of inspection, to keep their knowledge and skills up dated. Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 Page 6 People said they enjoyed the food they were given and said that there was a good choice. One person said ‘the meals are great. The food is always cooked just to my liking’. 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. The summary of this inspection report can be made available in other formats on request. Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. People’s needs are properly assessed prior to admission to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans I looked at showed that comprehensive pre-admission assessments had been carried out before offering someone a place. This is to make sure that the home can meet the person’s needs. A senior member of staff visits the person at home or in hospital to discuss their care needs. Social Services assessments are also used to determine this as well; these were also available to look at. People are welcome to visit the home before reaching a decision. I also looked at contracts people have with the home. These were detailed and included a breakdown of the fees and who was responsible for paying for the care provided. The home does not provide intermediate care. Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10 Quality in this outcome area is adequate In most cases people’s health and care needs are being met, however there was poor practice surrounding how medication is managed, and people’s privacy and dignity was not always protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: I looked at four care plans in detail, to make sure that people’s health and personal care needs are being met in the way the person prefers and to help them maintain their health and well-being. Generally they were well written and up to date. Risk assessments were in place and these had been reviewed and updated when people’s requirements had changed. The deputy manager is currently updating all the care plans. The way in which peoples medication is looked after by the home is an area of concern. At this inspection some tablets had not been stored properly, the medication administration records were not completed accurately and tablets Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 Page 10 were difficult to audit due to amounts of tablets received into the home not been recorded. The manager and deputy manager said they would look into these things as a priority, and make sure that the recording of stock tablets was brought up to date and that tablets were stored correctly. From observation some peoples privacy and dignity was not always protected by staff. Some examples of this were, one member of care staff stood between two people who needed assistance with eating their lunch. The member of staff was feeding both of these people at the same time and talking to another colleague who was also supporting someone to have their lunch on another table. Also, in the communal bathroom on the upper floor a ‘bath list’ was displayed denoting what day each person was given a bath. In the same bathroom a trolley was set with towels and bed linen on the bottom of the trolley were several pairs of slippers that appeared to be for communal use. One person had been left in their bedroom to eat lunch. This person was still in their nightclothes, the buttons were not done up on the nightgown, this person was not covered with a blanket, and had nothing on their feet they were cold to touch. The manager was shocked and disappointed that staff had left this person like this and took action immediately to make this person more comfortable. Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 Page 11 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 &15 Quality in this outcome area is adequate. Some people do not have any choice over how they spend there days. The opportunity for people to take part in activities was limited. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An activities organiser has been recruited to the home. She was not on duty during this inspection. People looked bored, most were sat in the lounge areas with the television on. Some people were in there bedrooms reading. In the dementia unit a radio was playing indiscriminately most people on this unit were asleep in chairs. We asked the people who lived at the home how they spent there days. Most said watching television. One person said ‘the staff are very busy, sometimes it would be nice if they just sat and had a chat with me but I don’t like to bother them’. Another person said ‘ I sometimes get out to the shop and bookies it all depends’. The ladies said they enjoyed a visit from the hairdresser and looked forward to this. Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 Page 12 People said that their visitors were made welcome and they could meet them in private if they wanted to. The lunchtime period was observed in both dementia unit’s dining areas, it was chaotic. It is my view that there was not enough staff to assist people over this busy period, and some people were left with a plate of food going cold until a member of staff had chance to give some assistance. Another person was continually asking to leave the dining room and was ignored. As mentioned in the previous standard one member of staff was assisting two residents to eat at the same time, whilst talking to another colleague. Plastic beakers for hot drinks are used indiscriminately, these were stained and grubby. None of the tables in the dementia units were set properly. They did not have a tablecloth or condiments. Spoons were given out when pudding was served. However on a positive note everyone we spoke to said the food was lovely. There was a good choice and the food was nicely presented and well cooked. Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 Page 13 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 & 18 Quality in this outcome area is good. People can be confidant that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are adequate written policies and procedures in place to deal with complaints and the care staff spoken to confirm they were aware of these. Staff knowledge of these help ensure that they were able to address any issues or anxieties of the residents, relatives and visitors to the home. People who live at the home told me they would speak to the manager or any of the staff if they had any concerns or complaints. Staff told me that training has taken place in the protection of vulnerable adults in abuse. I looked at four personnel files and found that staff recruitment procedures were adequate and staff were employed and deployed following appropriate checks. The manager and staff team were clear and confident in the protection of vulnerable adult procedures. Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 Page 14 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 & 26 Quality in this outcome area is good. People live in a safe, clean and well maintained home This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the bedrooms that I saw reflect the person’s individual preferences and taste. There is a programme of re-decoration for the bedrooms, as well as for the rest of the home. Some new dining furniture has been bought for the upper floor dining room. New flooring had been laid in several areas of the home. The manager told me that the downstairs dementia unit was also about to be refurbished. The home was nice and clean. Staff told me there was always sufficient cleaning equipment and disposable gloves and aprons were available. There were no outstanding issues from the fire and rescue service inspection or from the environmental health inspection. Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28 & 30 Quality in this outcome area is adequate Whilst the recruitment and training of staff is good, staff are not deployed properly and some peoples need were not met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the morning of the inspection the home was not properly staffed. Some staff were attending planned training and a member of staff had been sent home. Despite the manager knowing about the training, he had not arranged to cover the shifts. He explained that he was on duty and the deputy manager to assist staff should staff require help. He said that this was an exceptional circumstance, however staff told me that it was a regular occurrence. They said ‘it’s always like this, all hands on deck’ and ‘we just try and manage the best we can’ As mentioned previously over the lunchtime period it is my view that there was not enough staff on duty to assist everyone who needed support. Staff were delivering meals to people in bedrooms, trying to assist people to sit at dining tables and getting people who were sat in armchairs in a position to eat lunch. One person who should be continually supervised by a member of staff during the day was often left unsupervised. The person who was assigned to do this Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 Page 16 on the day of inspection was busy assisting other people throughout the day, sometimes in a different area of the home. The manager needs to review the routine of the home especially the mealtimes which appeared unorganised, staff need to be supervised and deployed properly so that people’s identified needs are met safely. I looked at a selection of staff files. They all included completed application forms and two written references. The files showed that satisfactory Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks have been obtained. I was assured that no new member of staff starts work until a POVA register check had been completed. Then, if the CRB check had not been received, they would work only under the supervision of an experienced staff member. The manager makes sure that staff have the necessary training to help them do their work as well as possible. There is a wide range of courses available and the records confirmed that the staff are allowed the time to attend. Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 Quality in this outcome area is adequate Some aspects of people health, welfare and safety would be better served if the home had a registered manager, with clear lines of accountability. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has been in post for four months, as yet he has not registered with the Commission. The home has not had a registered manager for over two years. Staff need to be properly supervised and have clear lines of accountability in order that they can deliver care and meet peoples needs properly. There are several issues that have been identified in the report that require the manager to take action; all of these issues were discussed at the inspection. Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 Page 18 The home has a quality assurance system, and the company have a very good audit system. The area manager carries out a quality assurance and monitoring visit on a monthly basis. A report of these visits are held at the home, and covers all aspects of care delivery and environmental issues. Despite issues identified during these monthly audits, in some instances there was no evidence to suggest that action had been taken to rectify any shortfalls. I looked at the records held at the home regarding people’s personal allowance. All transactions are recorded correctly and receipts are kept. One person’s money was counted and matched the total on the record. Policies and procedures are kept up to date; to make sure they provide relevant information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner. I looked at some certificates to make sure that equipment was safe and had been maintained. All these measures make sure that the health, safety and welfare of the people who live at the home is promoted and safeguarded. Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 Page 19 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 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP31 Regulation 12 Requirement The acting manger must submit an application to the commission for social care and inspection to become the registered manager without delay. Timescale for action 30/05/08 2 OP9 17 To ensure people get their medication properly and to reduce the risk of harm • Medication administration records must be completed accurately and signed by the person who has administered the medication. • Medication must be stored correctly and manufacturers guidelines for storage of certain medication adhered to. Unless a person’s plan of care suggests otherwise, people should be dressed properly and arrangements made to protect their privacy and dignity at all times. DS0000000746.V354419.R01.S.doc 22/01/08 3 OP10 12 22/01/08 Rydal Road Care Home Version 5.2 Page 21 4 OP12 16 5 OP27 18 People need to be offered a variety of social and recreational activities that meets their expectations and preferences. To ensure that people receive the care and support they need, staff must be employed and deployed properly. 31/05/08 22/01/08 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 Refer to Standard OP12 OP10 Good Practice Recommendations It is recommended that a review of the mealtime routine takes place, to ensure people get the appropriate level of support they require. It is recommended that all staff are given further training in maintaining peoples privacy and dignity. Rydal Road Care Home DS0000000746.V354419.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection North Eastern Regional St Nicholas Building St Nicholas Street Newcastle upon Tyne NE1 1NB 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 Road Care Home DS0000000746.V354419.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. 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