Inspection on 28/10/08 for Ryecourt Nursing Home

This inspection was carried out on 28th October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ryecourt Nursing Home 04/01/07

Ryecourt Nursing Home 21/11/05

Ryecourt Nursing Home 13/06/05

Ryecourt Nursing Home 28/09/04

Ryecourt Nursing Home 10/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ryecourt Nursing Home Ryecourt Nursing Home 264/266 Queens Promenade Bispham Blackpool Lancashire FY2 9HD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jacqueline Riley     Date: 2 8 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Ryecourt Nursing Home 264/266 Queens Promenade Ryecourt Nursing Home Bispham Blackpool Lancashire FY2 9HD 01253592905 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ryecourt Limited Name of registered manager (if applicable) Mrs Jean Hepburn Wilson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home with nursing - Code N To Service Users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is: 35 Date of last inspection Brief description of the care home Ryecourt care home provides residential and nursing care for 22 older people and 13 people with dementia. The home is situated on the Promenade, overlooking the sea in Bispham and is close to local amenities. The home is within easy access to the beach, local shops, banks, the library, public houses and bus and tram routes. Care Homes for Older People Page 4 of 27 care home 35 Over 65 0 35 35 0 Brief description of the care home Accommodation within the home includes four day rooms and two dining areas. Thirtyone single bedrooms of which twenty-seven have en-suite facilities. There are also two double bedrooms. There are two individual units in the home, one for residents who are elderly and one for residents who have dementia. Both units provide a high standard of facilities, including specialist bathing and mobility equipment. The home has a Statement of Purpose and user guide providing information about the services the home will provide to residents and their families whilst living there. A copy of the Service User Guide is issued to all prospective residents and/or their families or representatives to help them make an informed choice whether to move into the home. At the time of the inspection the range of fees were 361.06 pounds, to 540.00 pounds per week. In addition weekly charges for continuing care are 570 pounds. Additional variable charges are made for Chiropody, hairdressing and additional toiletries. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection and took place over a five hour period, on 27th October 2008. We spoke to the general manager, registered manager,three staff members, visitors and a number of residents. We spent time in two lounge and dining areas of the home making general observations to get a flavour of how the home operates on a daily basis. As part of the inspection process we talked to people using the service and asked staff about those peoples needs. We also looked at their rooms, care plans, records and daily notes this is called case tracking. We also invite others using the service to pass Care Homes for Older People Page 6 of 27 on their opinions if they wish. We had responses from questionnaires sent to people who use the service for their views on how they experience the service. Comments in general were positive and some are included in this report. Every year the person in charge or manager is asked to provide us with written information about the quality of the service they provide, and to make an assessment of the quality of the service. We use this information, in part, to focus upon our inspection activity. We looked at recruitment and training records of three staff members. We walked around the building and watched people living and working in the home to see how everyone supported and talked to each other. What the care home does well: What has improved since the last inspection? What they could do better: We looked at three residents care plans, whilst there is information about the residents needs, some of the information was limited including, risk assessments and nutritional needs.We say these are areas where staff need to be informed so that they know what the individual needs of residents are and can then provide the level of care identified in these areas. We saw there were not always up to date reviews in the area of care planning which might be detrimental to residents. There is a need to make sure the residents care plans are reviewed so that their level of care is appropriate to their current needs. Staff induction records were limited in how they demonstrate a member of staff is competent in various areas of care they should evidence of how competent they are in various areas of care and that there is evidence the staff member has been involved in the induction training process. Staff training must be improved upon so that all staff receive updates on training which is time constrained including moving and handling, first aid. In addition whilst training in safeguarding people was going to be provided following the last inspection, we found this has not taken place. It is essential people using the service are protected and the staff team must show they are competent in this area through a training programme. Care Homes for Older People Page 8 of 27 Whilst there is an activity programme in place it could be further developed for residents with dementia type conditions so that they have the opportunity to experience activities which are suitable to meet their specialist needs. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Admission and assessment procedures are clear to ensure the needs of residents are met. Information about the service is up to date, and given to people using the service, so that they are fully informed. Evidence: We looked at the records of three residents, they had assessment details recorded, both by the home and other agencies including social workers and health workers. The details provide the home with information about the residents and what their needs are. This information is used to form the basis of a care plan. As well as providing information about their care needs it also informs the home of any cultural needs so that they are not disadvantaged in any way. Comments we received included, all the residents are assessed either by us , the social worker or the hospital before they come here so that we know what there needs are going to be. They came to see mum before she came here, and I came and had a good look round, the information we got Care Homes for Older People Page 11 of 27 Evidence: was good. We looked at the homes new Statement of Purpose and Service User Guide. There is now more information included so that people using the service know what to expect. The home does not provide intermediate care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Promotion of health is taken seriously. Residents welfare is monitored and health and personal needs identified, so that their general health is maintained. However, limited information in care plans could have a detrimental affect on residents. Evidence: We looked at the care plans of three residents, they were found to cover all areas of care including health, and personal needs. In general all the care plans seen had information which is constantly updated but not always reviewed on a regular basis. Two of the care plans seen had reviews in areas of health care however they were not up to date in areas of nutrition and moving and handling. This is not in the best interest of the residents welfare. We looked at how residents levels of risk are assessed. Whilst some of the records identify risk in specific areas of the care plan, there is no recognition of environmental risk factors and falls risk for residents. This is an area which should be developed further to minimize their level of risk. Care Homes for Older People Page 13 of 27 Evidence: On all three files looked at we found there was no evidence the resident or an advocate has been involved in the care planning process. We say that wherever possible this should occur so that the resident or advocate is involved in how their care planning is being developed. Medication practices we saw at lunchtime were safe and good records had been kept to make sure a residents health is maintained. Only trained nursed are responsible for the administration and management of medication procedures. We spoke to the manager about training updates in this area and were told the home uses current department of health guidance in this area, so that staff are following current requirement in this area. We looked at how the home makes sure residents privacy and dignity is upheld. We spent time in two lounges and saw how staff responded to residents individually and as a group. In all instances we saw staff talk to residents with respect, they are sensitive when helping them in tasks. Comments we received said, the staff are very good and always listen to my relative. They have so much patience. We make sure residents are getting what they ask for, it can be challenging sometimes, especially when residents have dementia. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Daily life and social activities are generally flexible to meet individual needs, however there was little evidence of activities designed to meet the needs of residents with dementia, which has the potential to disadvantage them. Evidence: We spoke to residents and staff about routines in the home and they were found to be flexible. By talking to people and looking at daily records we could see there are no restrictions in the residents daily lives. Comments included, Residents have their own routines, some like to get up and go to bed early others like to get up late and stay up late. One residents said, I like to go out every day at lunchtime if the weather is OK. Whilst spending time in two lounges we saw residents moved around them. In the dementia unit, residents use the large lounge area to wander around and talk to people without restriction. There is always a member of staff in the lounge area at any time in the dementia unit for the health safety and welfare of the residents. Comments included, we are always around here, because there are times when we need to watch individual behavior. Some of the residents just like to sit quietly and others like to chat, there is a real mix. Care Homes for Older People Page 15 of 27 Evidence: During the morning there was a music session in one of the lounges with a member of staff. Residents chose what music they preferred and there was time spent listening and singing to music. We saw the staff encouraged residents to participate, many did, but some chose not to and staff respected this. comments included, I like to listen to this music it brings back memories of some good times. There are activities including music, board games, card games and a singer visits once a week. Comments included, I like to do my own thing, the singer is good but I like the music anyway. Whilst there are activities in place for residents, there was little evidence of specific activity designed for residents with dementia. We suggest there should be further development in this area, so that they are varied and suit their capacity. The way meals are prepared and served were seen to be good. There are two dining areas in the home, in addition to this some residents choose to eat their meals in the privacy of their own rooms. A lunchtime meal was served which residents were seen to enjoy, comments included, the food is always nice and if I dont like something they will always give me another option. We saw staff assisting a number of resident with eating and this was done in a sensitive manner, with staff sitting with the resident and talking to them. We saw there are no restrictions to visitors at the home, during the morning period we saw a number of visitors come to visit family and friends. Comments included, I can come anytime they are always welcoming. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are taken seriously and handled well making sure people feel listened to. Lack of staff training in safeguarding people has the potential to put people at risk. Evidence: We looked at the homes complaints procedure which is made available to residents and their relatives or advocate during the admission process. Comments we received told us people are aware of how to make complaints or raise concerns with the service. We were told people felt confident to raise any concerns if they were not happy about something. Staff said they would know what to do should a concern be raised. There have been three complaints investigated by the home in the last twelve months. They were found to be unsubstantiated and we were satisfied with their investigations. We saw the home has procedures based upon current good practice guideline for the safeguarding of people. We spoke to staff about this and whilst they are aware of the guidelines and issues around safeguarding people, staff have not yet attended training in this area. We say it is necessary for staff to receive training in safeguarding people so that people using the service are protected. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is safe and clean, maintained to a high standard, providing comfortable surroundings for residents to live in. Evidence: We looked at the homes layout and design and found it to be a homely and comfortable environment in which to live. There are two units in the home, one for general care and the other for dementia care. We looked at the communal spaces on both units and found the to be spacious, decorated and furnished to a high standard. Comments included, Its always nice and clean, and the rooms are really comfortable. I like to sit and watch things going on. We looked at how residents move around and what they like to do when sat in lounges. It showed us residents could move around without restriction. They were seen to talk to each other in a relaxed fashion. We toured the home and looked at individual rooms. Most of the rooms are personalized with residents own personal belongings, which helps them to feel comfortable with familiar things around them. Decoration in all rooms was good. The issues regarding the heating of three rooms in the previous report have now been addressed, and all rooms were heated and ventilated to a good standard. General comments received said the home was a nice environment to work in, and Care Homes for Older People Page 18 of 27 Evidence: staff found the facilities available to them helped them in the care of residents. We saw there is a range of bathing facilities in the home to meet the needs of the residents living there. There are specialized bathing facilities for residents with limited mobility or disability. The laundry facilities are suitable to meet the control of infection, with policies and guidance to follow this up. Water temperature were checked and found to be within health and safety guidelines. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The procedures for the recruitment of staff are good ensuring the safety and protection of residents. Training for staff is limited which means their knowledge of current good practice could be affected. Evidence: We looked at duty rotas and discussed staffing levels with the manager. They confirmed there were enough staff on duty to make sure residents are supported and their needs are met. Staff members spoken to said that although they are busy they are satisfied they are meeting the needs of residents. Comments included, we work well as a team. There have been some staff changes but we are all working well together. We looked at three staff files which confirmed the home makes sure all necessary checks are carried out before an applicant starts to work at the home. Staff records include, application forms, Criminal Records Bureau, Protection of Vulnerable Adults checks and references so that residents living at the home are protected. We looked at how staff are trained. We saw there are records in place for staff induction training when they begin work at the home. Whilst they show staff have completed tasks in a number of areas associated with their roles, they would benefit Care Homes for Older People Page 20 of 27 Evidence: from more detail in respect of how they meet the competence in any one area, and for there to be evidence of the member of staff being involved in the assessment process. We spoke to the management team about this and they agreed to review the current system. We saw some staff have on file copies of courses attended, however they tended to be out of date. There was no clear evidence of what training is available and no record of staff attending training. As previously stated staff have not attended safeguarding training which is necessary for the protection of users of the service. There was little evidence of staff receiving training into the specific needs of residents with dementia, which could be detrimental to the service. Comments included, Ive done my NVQ and it covered most things. Ive had a bit of training on dementia a while ago. There is a need for the home to review its training records for staff and for the management team to promote training in areas of care which are essential for staff in order to provide good standards of care based upon current good practice. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed using policies and procedures for the safety and well being of residents and staff. Evidence: We saw the manager has the necessary skills and experience required to support staff and residents on a day to day basis. Comments included, I feel the manager supports us. You can always go and talk to someone at any time. There is a general manager in post who is working closely with the registered manager to develop the service further. This is being carried out by reviewing the systems currently in place and making changes where necessary. We were told the home requests the views of users of the service and there is an open door policy by which staff residents and residents or advocates can make comments. We say there should be some formal focus on getting the views of people who use the service, and this could be in the form of staff meetings and resident meetings, so that any views or Care Homes for Older People Page 22 of 27 Evidence: issues raised could be used to measure the homes effectiveness against its stated aims and objectives. We saw the home manages residents monies on occassions, and that there are clear records to record and monitor this, so they are protected. The information we were provided with told us the home checks all appliances regularly for the health and safety of all users of the service. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 There must be evidence of 01/12/2008 risk assessment in all aspects of care on each care plan. By not providing risk assessments in some care plans for nutrition, moving and handling and environmental risk residents may be put at additional risk. 2 7 15 There must be evidence all care plans have a full and regular review on all areas of care. By not reviewing all areas of care resident may not be receiving the level of care they require. 01/12/2008 3 30 18 All staff must have access to 30/01/2009 training appropriate to their roles. Lack of training in areas of safeguarding people, up dates in moving and Care Homes for Older People Page 25 of 27 handling and lack of specific dementia care training has the potential to disadvantage people. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Wherever possible residents, relatives or advocates should be involved in the care planning process so that people can contribute to the care being provided at the home. The home should look at good practice areas for the further development of activities designed to meet the needs of resident with dementia type conditions, this would provide stimulation which is suitable to meet their needs. The home should develop its quality monitoring system so that the development of the home is based upon the comments and views of people who use the service. 2 12 3 33 Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 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!