CARE HOMES FOR OLDER PEOPLE
Rydal Road Care Home Rydal Road Darlington Durham DL1 4BH Lead Inspector
Bridgit Stockton Unannounced Inspection 28th February 2007 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.V330361.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.V330361.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) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) 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.V330361.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. 12th October 2006 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 residents. Rydal Road Care Home DS0000000746.V330361.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was carried out over a period of 6 hours on 28th February 2007. The plan for the inspection was to check whether the home had met previous requirements and recommendations; to talk with service users about living in the home; to meet with staff and the home’s management team; and to look at records. Some comments received from service users and relative surveys have also been included in this report. What the service does well: What has improved since the last inspection?
Since the last inspection the manager and staff team have worked very hard at sustaining a good level of service for the people who live at Rydal Road Care Home. How service users planned care is recorded in service users care plans has continued to improve, demonstrating how staff actually care for people at the home. A program of redecoration and refurbishment is ongoing; most of the communal areas have now been redecorated and new carpets or flooring fitted. All staff have been brought up to date with fire training and fire drills, and the commitment to having a fully trained workforce at the home is evident. The company, to ensure a quality service is being offered at the home has produced new audit systems. This has just commenced and the manager was about to complete the first audit. Rydal Road Care Home DS0000000746.V330361.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Rydal Road Care Home DS0000000746.V330361.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.V330361.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): 1,2,3,&6 Quality in this outcome area is good. Prospective service users can be assured that their needs are appropriately assessed prior to admission to the home and that they are given sufficient information to make an informed choice before moving into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s Statement of Purpose and Service User Guide have been updated. These guides contained all of the information that is required to enable people to make an informed choice about where to live. Evidence was seen in service users files that service users or their representatives had signed a contract. The contracts were detailed and included a breakdown of the fees and who was responsible for paying them. The manager confirmed that visits to prospective service users takes place before their admission to the home, to carry out an assessment of needs. Four care plans examined contained notes from assessments made on these visits. Also, each service users care plans contained assessments from the
Rydal Road Care Home DS0000000746.V330361.R01.S.doc Version 5.2 Page 9 placing authority that were responsible for commissioning the service users care at the home. The home does not provide intermediate care Rydal Road Care Home DS0000000746.V330361.R01.S.doc Version 5.2 Page 10 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 good. Systems are in place to ensure that health care needs of the service users are met. Service users can be confident that their privacy and dignity is protected and that they are treated with respect This judgement has been made using available evidence including a visit to this service. EVIDENCE: A service user plan has been developed for each service user that identifies needs associated with health and personal care. This ensures that staff are clear about what is required of them in meeting their needs. The care plans of four service users were inspected. They were comprehensive and demonstrated the support and care the individual received. There was evidence of involvement of specialist healthcare people such as the community psychiatric nurse, the dietician and continence nurse. Staff were seen to be treating service users with respect and dignity and this was also reflected within the care plans. Service users said that the ‘girls are kind’ and ‘they are all smashing every single one of them’. A service user commented in a questionnaire ‘this is the best home I’ve ever been in’.
Rydal Road Care Home DS0000000746.V330361.R01.S.doc Version 5.2 Page 11 Service users medication was inspected. The home operates a monitored dose system, which was working well. Staff need to be more careful when administrating medication that is not in the monitored dose system, to ensure that service users receive their own prescribed medication. Rydal Road Care Home DS0000000746.V330361.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,&15 Quality in this outcome area is good. The recreational and social needs of service users are well catered for which enables service users to make daily choices and promotes independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a busy and purposeful atmosphere, some service users were enjoying chatting with each other, some were listing to music or else joining in with a group activity. Visitors at the home said they were always made to feel very welcome, and there was always a ‘friendly, easy going atmosphere’. One service user said, ‘I get out three times a week for a lottery ticket and a beer’ All of the service users said the food was good, a choice of meals were offered and the menus were well thought out, catering for most people’s tastes. The lunchtime meals were nicely presented and service users said ‘it’s lovely, nice and hot and really tasty’ Rydal Road Care Home DS0000000746.V330361.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. Service users 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 confirmed they were aware of these. Staffs knowledge of these policy and procedures help ensure that they were able to address any issues or anxieties of the residents, relatives and visitors to the home. 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.V330361.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. The home was clean, comfortable and well-maintained providing service users with a safe and pleasant environment This judgement has been made using available evidence including a visit to this service. EVIDENCE: Some service users bedrooms and all the communal areas and bathrooms were inspected. These were all nice and clean and fresh. One service users said ‘ this place is always spotless, my room get cleaned everyday’. The bedrooms and communal areas were comfortably furnished, and all the dining rooms were bright and airy. Staff confirmed that they had disposable gloves and aprons to use when they were required. Staff have been recently trained in infection control. There were no outstanding requirements from the fire and rescue inspection report. Rydal Road Care Home DS0000000746.V330361.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): 27,28,29,30 Quality in this outcome area is good. Service user can be confident that staff are trained and on duty in sufficient numbers to meet their assessed needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was evidence of on going training for staff in such things as dementia care, moving and handling of service users, fire awareness and prevention of falls. All care staff are encourage by the company to be trained to NVQ level two or above. From the rota supplied with the pre inspection questionnaire there was sufficient care staff on duty to meet the assessed needs of service users. Service users said that staff were always around and answered the call bells quickly. One service user said ‘the staff are always popping in to see if I am okay ’. Another service user said ‘ they are well trained and always around if you need a hand’. Rydal Road Care Home DS0000000746.V330361.R01.S.doc Version 5.2 Page 16 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. Although management tasks are completed satisfactorily service users interests would be better served by having a registered manager. Systems and safeguards are in place to ensure the health, safety and welfare of service users and staff is protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is not registered with the commission. An application needs to be submitted without delay so this matter can be dealt with. Some service users personal allowances are held at the home. Financial policy and procedures are in place to ensure that all transactions can be accounted for. Receipts are retained and signatures obtained for any financial transaction regarding service users money.
Rydal Road Care Home DS0000000746.V330361.R01.S.doc Version 5.2 Page 17 There is a company policy in place to gain views of the users of the service. A report of which is fed back to the manager of the home, via the area manager who conducts regular quality assurance visits to the home. The homes health and safety file was examined; all equipment in the home is regularly checked with valid certificates issued. There are no outstanding issues from environmental health inspections or the fire and rescue services. Rydal Road Care Home DS0000000746.V330361.R01.S.doc Version 5.2 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 3 3 X 3 X X 3 Rydal Road Care Home DS0000000746.V330361.R01.S.doc Version 5.2 Page 19 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 30/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Good Practice Recommendations Rydal Road Care Home DS0000000746.V330361.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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
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