Inspection on 01/02/06 for Ryecroft Care Home

This inspection was carried out on 1st February 2006.

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

Ryecroft Care Home 02/03/07

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Ryecroft Care Home 1 Kings Avenue Meols Wirral CH47 ONH Lead Inspector Peter Cresswell Unannounced Inspection 1st February 2006 09:00 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 Ryecroft Care Home DS0000065801.V281872.R02.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. Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ryecroft Care Home Address 1 Kings Avenue Meols Wirral CH47 ONH 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) 0151 632 1068 0151 632 2890 Balvinder Basi Kamaljit Singh Basi Diana Elizabeth Meadows Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28 September 2006 Brief Description of the Service: Ryecroft is a detached, three storey property in the residential area of Meols in Wirral. The home is on a main road, near to bus routes, the beach, shops, post office, a church and other community facilities. Ryecroft is privately owned and has changed ownership since the last inspection, though the registered manager remains in post. The owners live outside the area but are active in its management and visit the home about twice a week. Ryecroft is registered to accommodate 13 older people in 11 single rooms and one shared room, all but two of which have en-suite toilet facilities. A fiveperson passenger lift serves each floor. The home was full at the time of the inspection. Residents also have the use of a main lounge (with a small sun lounge attached), separate dining room, a small smoker’s area in the porch and a small lounge on the second floor. There is a sheltered patio garden with garden furniture. Ryecroft is not suitable for independent wheelchair users as there is a step leading to the bathroom and lift on the ground floor but the Registered Person has plans to remedy this in the very near future. Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the inspector spoke to a number of residents, the Registered Manager and staff. He examined records concerning training, fire safety, care plans and catering. The inspector toured part of the building including the kitchen and food stores and also inspected documents including care plans, safety records, training records and the home’s medication records and procedures. What the service does well: 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. Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 Page 6 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 Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 Page 7 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): 2, 3, 4, 5. Ryecroft’s assessment and admission procedures ensure that residents are only admitted if their care needs can be met. Prospective residents and their families are encouraged to visit the home before moving in, ensuring that the home suits their needs and preferences. EVIDENCE: The inspector examined files for residents admitted since the last inspection. People who may want to move into Ryecroft are assessed by the Registered Manager or, sometimes, her deputy. The assessment is recorded, retained on file and forms the basis of the care plan if the person does move in. Prospective residents and their families are encouraged to visit the home before making a final decision so that they can see if they like the home and also to see if they can manage, for instance, the step in the hall. If Ryecroft is no longer able to care for a resident the Registered Manager arranges for reassessment. Contracts were on file though two of them were not yet signed. The Registered Manager said that she was in the process of arranging this. Ryecroft does not provide intermediate care so standard 6 does not apply. Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 Page 8 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): 7, 8, 9, 10. Effective care plans, risk assessments and daily reports help to ensure that residents receive care that is appropriate to their needs. Medication procedures are satisfactory and protect the welfare of the residents. EVIDENCE: Care plans and risk assessments are on file for all residents. Care plan summaries and daily reports are easily accessible to staff. More detailed documents, such as the original assessments, are kept in individual files. The Registered Manager and care staff review care plans at monthly meetings and minutes are kept of those meetings, with care plans being amended where necessary. All residents are registered with a General Practitioner of their choice and have access to community and specialist health care as required. Visits by health professionals are recorded on file. Residents’ weight and blood pressure is monitored and case files note the name they prefer to use. If changes in blood pressure are observed the resident’s doctor is notified. Medication is well organised and the home is now using a slightly different type of monitored dosage system. The community pharmacist provides tablets in sealed cassettes each month. Medication is well organised, securely stored and accurately recorded. Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 Page 9 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. Ryecroft provides a wide range of activities to enhance the lives of its residents. The menu is varied, well balanced, served at reasonable times, and informed by the residents’ opinions, thereby meeting their needs and tastes. EVIDENCE: Residents at Ryecroft get up and go to bed when they choose; on the day of the inspection residents were getting up at different times of the morning and having breakfast when it suited them. The home employs two part time activities organisers for a total of 20 hours a week. One of the organisers also works as a care assistant but her different roles are clearly separated. One of the organisers focuses on arranging quizzes, music, discussions and practical activities whilst the other takes residents out into the community. She sometimes uses her own car for this and is appropriately insured. Residents say that they enjoy the activities very much. The home has plans for activities throughout the coming year, including a ‘race night’, and trips to the theatre, Chester Zoo, a canal narrowboat and a steam train. One resident also goes out on his own and went to the shops on the morning of the inspection. Residents have single rooms – apart from one married couple, who share a room – and are able to receive visitors either in their own room, in the second floor lounge, or in the small sun lounge annexe to the main lounge. Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 Page 10 The main meal of the day is served at around 1pm, with a lighter tea served at around 6pm; times which are chosen to suit residents rather than staff. The menu is varied and although formal choices are not on the menu, alternatives are always available on request. Residents spoke very highly of the quality of the meals. Meals are discussed at residents’ meetings and the minutes indicated that they hold lively, detailed discussions, with their suggestions and requests being acted on by the Registered Manager and the cook. One recent meeting included a discussion on how well the vegetables should be cooked, the residents favouring ‘mushy’ texture, the cook ‘al dente’. The cook reluctantly agreed to the residents’ request. Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 Page 11 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, 17, 18. The home’s policies for dealing with complaints and allegations of abuse protect the interests of the residents. EVIDENCE: Details of the complaints policy and procedure are given to each resident. The complaints file was not examined on this occasion as the Registered Manager said that no complaints had been received since the last inspection. Policies and procedures on the prevention of abuse are in place, including the multiagency procedures for Wirral. Residents and their families are advised of advocacy services when they are admitted to the home. Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 Page 12 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, 20, 21, 23, 24, 25, 26. The home is safe and well maintained, ensuring residents’ safety and comfort. Residents have well furnished rooms, most with en suite facilities, ensuring their privacy and comfort. EVIDENCE: Ryecroft is on a main road, close to public transport and other community facilities. The home is not suitable for independent wheelchair users, particularly as there is a step in the hall, between the lounge and the ground floor toilet. Residents are normally helped to negotiate the step, and handrails are fitted, but some of them do so on their own. The new owners have plans to eliminate the step, which would be a huge improvement and would make the ground floor more easily accessible and convenient for the residents. It would not necessarily make the home suitable for independent wheelchair users as the corridors are quite narrow and there are some steps in other areas of the home. If any residents use wheelchairs from time to time they are assisted by staff. The home is clean, odour free and has a maintenance schedule, including imminent plans to redecorate some bedrooms. The changes to the ground Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 Page 13 floor will include the replacement of the corridor carpet, which is now overdue. The glass in a fire door on the first floor was cracked and must be replaced. Residents have single bedrooms apart from one shared room occupied by a married couple. A few bedrooms were inspected on this occasion and they were clean, comfortable and spacious; all but two bedrooms have ensuite toilet facilities. Many residents choose to spend time in their rooms, all of which have televisions. There are also televisions in the main lounge and the second floor lounge. The small lounge on the second floor is comfortably furnished, though it is not centrally heated and was very cold on the day of the inspection. It does have a freestanding heater and this should be the subject of a risk assessment if it is used. The Registered Manager said that residents do not use the room very often. Smoking is restricted to the sun porch near the entrance, which was very cold during the inspection. The last two inspection reports have suggested that an extractor fan might be fitted. This has not yet been done but if this area is to remain the only smoking area it would make it more comfortable for residents to use. Ryecroft has two assisted baths and a shower and this meets the minimum standard. The former first floor bathroom is now used as a staff sleep-in room. Ideally there would be a bathroom on the first floor so that residents on that floor do not have to go to another floor for a bath, but this would need other arrangements to be made for sleeping in. This may be an issue for consideration if any structural changes are made. Most radiators in bedrooms have guards fitted but some in public areas do not. It would be good practice to fit guards to all radiators, especially as many residents are now frail and use mobility aids. The kitchen is well organised and clean. Food stocks are rotated and fridge and freezer temperatures regularly recorded. Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 Page 14 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. Sufficient care staff are employed to meet the needs of the residents. Domestic staff need to be employed to ensure that current high standards of cleanliness are maintained without compromising standards of care. EVIDENCE: On weekdays the home is staffed by the manager and two care staff; at other times there are always two care staff on duty. At night there is a waking carer and a senior member of staff sleeping in. Activities organisers are employed for a total of 20 hours a week. Three staff have NVQ2 or above, three more are due to achieve the award in February 2006 and one has just started a course. One of the qualified staff gained her qualification abroad and has had her qualification assessed by NARIC (the appropriate Government agency). The home therefore currently falls short of the standard of 50 of care staff with NVQ2 or above, though this should soon be remedied. The Registered Manager is carrying out a programme of staff supervision that focuses on a series of designated topics and is fully recorded. The Registered Manager has not yet received a CRB/POVA check for one member of domestic staff, despite a request being made shortly after the last inspection. The Registered Manager is pursuing the matter urgently with the CRB and the home’s umbrella body, the National Care Homes Association. This difficult position has not been created by the Registered Person, who has only just been registered, and has been bequeathed by the previous owner. Nevertheless the situation needs to be resolved as a matter of urgency as it Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 Page 15 clearly breaches Regulations. In the meantime the Registered Manager is ensuring that the member of staff in question only has contact with residents under supervision. Regular unsupervised contact with residents would not in any event be a normal part of this member of staff’s duties. At the time of the inspection the home had no cleaning/housekeeping staff as one had just left. Cleaning and domestic duties were being covered by care staff, partly through overtime. It is important that domestic staff are employed to ensure that care staff are not deflected from their main duties. Standards previously issued by Wirral Borough Council indicated that a home of this type should provide 65 domestic hours. As cooks are employed for 28 hours, this would indicate that 37 other hours should be provided to provide cleaning, laundry and other domestic duties. The Care Homes Regulations and the National Minimum Standards do not specify detailed standards for domestic hours but sufficient such staff must be employed to ensure that the home is maintained ‘in a clean and hygienic state, free from dirt and unpleasant odours’. Ryecroft is certainly clean, hygienic and odour free and it is important that permanent staffing arrangements are made to ensure that these standards are maintained. Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37, 38. The home is efficiently managed and its procedures for quality assurance and staff supervision help to ensure that residents are in safe hands. Fire safety procedures are in place to protect the residents’ safety. EVIDENCE: The Registered Manager is qualified and experienced. Regular staff meetings are held and staff are supervised. Ryecroft’s quality assurance process includes a questionnaire to relatives and residents and the regular residents’ meetings, referred to under standard 15. The new owners are taking an active part in the management of the home. The Registered Manager said that the home is actively considering applying for Investors In People status, which would provide an additional quality assurance framework. The home does not handle residents’ finances, which are dealt with by families or legal representatives. Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 Page 17 Accidents are recorded in the Accident Book and the individual forms are kept in a separate file so that they can be scrutinised individually if necessary. Several had not yet been removed on the day of the inspection; they should be filed as soon as they have been completed, in order to comply with the Data Protection Act. One of the owners is highly experienced in fire safety and prevention and he has completed a detailed Fire Risk Assessment Plan for the home. Fire safety checks were up to date Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 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 X 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 3 3 3 3 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 3 3 X 3 3 3 3 Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 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 2 Standard OP19 OP29 Regulation 23(2) 19(1) Requirement The cracked window in the fire exit door on the first floor must be replaced. The Registered Person shall not employ a person to work at the home unless they have obtained a satisfactory CRB check, POVA clearance (where appropriate) and written references. Timescale for action 01/03/06 02/02/06 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 3 Refer to Standard OP19 OP27 OP28 Good Practice Recommendations It would be good practice to fit an extractor fan to the small sun porch and radiator guards to central heating radiators in communal areas such as corridors. The Registered Person needs to employ sufficient domestic staff to maintain the home’s high standards of cleanliness. The home does not have 50 of care staff qualified to NVQ2 and needs to take steps to meet this target as soon as possible. Ryecroft Care Home DS0000065801.V281872.R02.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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. 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