Inspection on 23/05/06 for Rydal Road Care Home

This inspection was carried out on 23rd May 2006.

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 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 23rd May 2006 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.V294329.R01.S.doc Version 5.1 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.V294329.R01.S.doc Version 5.1 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) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) 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), Terminally ill (4) Rydal Road Care Home DS0000000746.V294329.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th December 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 DS0000000746.V294329.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced. The visit to the home took place over 11 hours and was conducted over two days. All of the key national minimum standards were inspected. The inspector spoke to some people who use the service, staff and the manager and inspected some of the records in the home. Prior to this the home manager had completed a self-assessment document to give the Commission for Social Care Inspection information required to aid inspection. Some service users had also completed comment cards on what they thought about the service at the home. On the whole service users were happy with the service they were receiving What the service does well: What has improved since the last inspection? The home has been redecorated and new furniture bought for some communal areas. The training that staff receive has improved and the manager has worked very hard in this area, the company is committed to having a fully qualified workforce. Rydal Road Care Home DS0000000746.V294329.R01.S.doc Version 5.1 Page 6 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 DS0000000746.V294329.R01.S.doc Version 5.1 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.V294329.R01.S.doc Version 5.1 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 the following standard(s): 3&6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective service users can be assured that their needs are appropriately assessed prior to admission to the home. EVIDENCE: The manager confirmed that she always visits prospective service users before their admission to the home, to carry out an assessment of needs. Four service users files inspected had pre admission assessments and care management assessments so that a decision could be made about whether the home was able to meet the needs of the individual. Intermediate care is not offered at Rydal Road Care Home therefore this standard was not assessed. Rydal Road Care Home DS0000000746.V294329.R01.S.doc Version 5.1 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 the following standard(s): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Care plans do not provide staff with enough detail for them to meet all the service users identified needs. Some service users cannot be guaranteed that there dignity and privacy is maintained. Service users are at risk due to poor practice in the storage and administration of medication. EVIDENCE: Four service users care plans were inspected. They were not written in enough detail to ensure that service users needs could be met. The care plans in place, that gave details about pressure sore treatment and intervention, were lacking in information. Upon reading the plans it was unclear as to what type of dressings were currently used and how frequently the dressings were being renewed. Rydal Road Care Home DS0000000746.V294329.R01.S.doc Version 5.1 Page 10 There was no reference in any of the files about the social and psychological needs of people. This was of particular concern where service users suffer from dementia. In addition some of the entries in the plans were illegible. Issues regarding care planning had been identified at the previous inspection, no improvement has been made. The manager must now take action to improve the recording in care plans, ensuring that plans are working documents and are relevant to the care that service users require, so needs can be met. During the visit to the home service users dignity was compromised. Several service users were found to be in urine soaked clothing. This is unacceptable. The manager acted immediately to rectify this. The medication at the home was difficult to audit as a new system had just commenced, and the number of tablets received into the home had not been recorded. The treatment room where the medication was stored was in disarray. Empty glass medicine bottles littered the working surfaces in the treatment room. Control drugs had not been destroyed when service users no longer required them. In one service users bedroom tablets had been left on a shelf that should have been locked away in the medicine trolley. Rydal Road Care Home DS0000000746.V294329.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 &15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users had some activities though would benefit from an activities organiser for a more structured individual approach. A good selection of meals with choices and alternatives are available for service users at the home. EVIDENCE: Currently the home does not employ an activities co-ordinator. People were observed to be sitting during the inspection with little stimulation or activity. One service user said ‘ I like to go out each day for a walk to the shops, I normally do get during the week, it depends which staff are on’. Some service users where sat outside enjoying the sunny day in the grounds of the home. Rydal Road Care Home DS0000000746.V294329.R01.S.doc Version 5.1 Page 12 Service uses are encouraged to maintain links with the community and visitors to the home were allowed to visit at any reasonable time. One service user said that her family and friends were always made to feel welcome at the home. All of the service users spoken to said that the meals were good. One service user said ‘ the meat is always lovely, we get really good sized portions, the choice is good to’ Rydal Road Care Home DS0000000746.V294329.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16&18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People can be assured complaints would be investigated and outcomes recorded. Staff were aware of measures to take in case of abuse of a vulnerable adult. EVIDENCE: There are adequate written policies and procedures in place to deal with complaints and the care staff spoken to confirmed they were aware of these. Written records of complaints and the outcomes are kept at the home. Service users said they would complain to the manager if they were at all unhappy. Staff training has taken place in the protection of vulnerable adults in abuse. Staff recruitment procedures were adequate and staff were employed and deployed following appropriate CRB and POVA checks. The manager and staff team were clear and confident in the protection of vulnerable adult procedures. Rydal Road Care Home DS0000000746.V294329.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19&26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The environment was adequate but needed improvements. Some areas of the home were dirty, hygiene was poor. EVIDENCE: The home was comfortable and decorated to a good standard. Service users said they liked their bedrooms, and enjoyed sitting in them watching television or reading. Rydal Road Care Home DS0000000746.V294329.R01.S.doc Version 5.1 Page 15 Some of the vinyl wheel chairs that are in the lounge areas are in need of replacement as the vinyl was torn and the foam stuffing was coming through. Some areas of the home were dirty. Some service users bedrooms smelt of urine, action must be taken to rectify this. The communal shower room had used face clothes dropped on the floor and radiator. A commode that was stored in the shower room was smeared with faeces on the seat. One service user was waiting for newly prescribed dressings to be obtained, the areas that required dressings were seeping fluid and left undressed. This service user was also diagnosed as having a contagious infection in these wounds. Staff on this unit were oblivious to the importance of infection control and left the wounds uncovered until challenged. Infection control procedures were not followed causing significant risk to the well being of people at the home. Rydal Road Care Home DS0000000746.V294329.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29, & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff were deployed in sufficient numbers and had sufficient training to meet the needs of the service users EVIDENCE: Staffing levels were satisfactory.47 of staff were trained to NVQ 2 or above in care. The home would benefit from employing an activities co coordinator to ensure service users social and recreational needs can be catered for. In addition the manager should explore the possibility of recruiting a deputy manager to the home to ensure that standards in service user care is achieved and maintained during her absence. There was a commitment by the provider to encourage staff to train and this has improved since the last inspection. Although staff had adequate induction and training some practices did not look after peoples dignity to an adequate standard. It is hoped this can be improved by change of practice and by proper close supervision of staff. Rydal Road Care Home DS0000000746.V294329.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35, &38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Although management tasks are completed satisfactorily service users interests would be better served by having a registered manager. Although robust financial procedures are in place, they are not being followed putting service users at risk. Service users health safety and welfare is not protected. Rydal Road Care Home DS0000000746.V294329.R01.S.doc Version 5.1 Page 18 EVIDENCE: The manager of Rydal Care Home is not registered with the Commission for Social Care and Inspection, this needs to be addressed and an application to become the registered manager needs to be submitted. Regular staff meetings take place. Staff supervision is taking place and records of this are kept on individual files. The records regarding administration of residents’ personal allowances were inspected. All transactions are recorded correctly and receipts are kept. A large sum of money had been spent from one service users personal allowance on a piece of equipment for their personal use. There was no evidence to suggest that the service user or a representative had been consulted before this money had been spent, this is not company policy. In addition an expert opinion for example from an occupational therapist had not been sought to ensure that this equipment was suitable in meeting the service users needs. As mention in a previous outcome staff do not follow infection control procedures, which puts people at risk. Training takes place in such things as moving and handling, first aid, and food hygiene. Some members of staff are not receiving fire training as regular as they should one member of night staff had not been updated for over a year. The manager must ensure that all staff are trained regularly in fire and rescue procedures There were health and safety checks taking place to ensure a safe environment. Equipment was being serviced regularly to make it was safe to use, and valid certificates were available for inspection. Rydal Road Care Home DS0000000746.V294329.R01.S.doc Version 5.1 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 1 8 3 9 1 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X X X 1 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 1 X X 1 Rydal Road Care Home DS0000000746.V294329.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 14 &15 Requirement The manager must • Review all care plans to ensure that the plan is up to date with the care that service users are receiving (previous requirement not met 28/02/06) • Timescale for action 03/07/06 2. OP8 15 Ensure that the recording in all service user care plans is legible The manager must ensure that a 31/05/06 Care plans contain more in depth information with regard to pressure sore assessment and treatment. (Previous requirement not met 28/02/06) 3 4 OP10 OP9 12 12,13, The privacy and dignity of service users must be maintained The manager must ensure that • All medication received into the home on behalf of a service user must be counted and signed for. 31/05/06 31/05/06 Rydal Road Care Home DS0000000746.V294329.R01.S.doc Version 5.1 Page 21 • Controlled drugs that are no longer required must be destroyed. All medication should be stored correctly. The treatment room where medication is stored requires tidying. 03/07/06 • • 5 OP19 12 6 OP26 13,16 The bedrooms that smelt of urine, identified at the time of inspection must be cleaned thoroughly and floor covering replaced. Any furniture or equipment that continues to smell following cleaning must also be replaced. The manager must • Ensure infection control policies and procedures are implemented to maintain an infection free environment for people. • • Ensure that the home is clean and hygienic. 03/07/06 7 OP35 12 All staff must attend infection control training. The manager must evidence how service users and or there representatives are consulted when staff on behalf of service users use personal allowances to buy equipment. All members of staff must receive fire training as stated by the fire and rescue services. 03/07/03 8 OP38 23 31/05/06 Rydal Road Care Home DS0000000746.V294329.R01.S.doc Version 5.1 Page 22 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 OP31 Good Practice Recommendations It is recommended that the acting manger submits an application to the commission for social care and inspection to become the registered manager. (Still outstanding from previous inspection of 09/12/05) It is recommended that the manager considers employing an activities co coordinator, and a deputy manager. 2 OP12 Rydal Road Care Home DS0000000746.V294329.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Darlington Area Office 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 DS0000000746.V294329.R01.S.doc Version 5.1 Page 24 - 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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