Inspection on 20/04/05 for Ryland View

This inspection was carried out on 20th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Ryland View 27/08/09

Ryland View 28/05/09

Ryland View 25/11/08

Ryland View 25/06/07

Ryland View 11/09/06

Ryland View 10/01/06

Ryland View 18/01/05

Ryland View 18/01/05

Ryland View 18/01/05

Ryland View 18/01/05

Ryland View 12/01/05

Ryland View 21/04/04

Ryland View 21/04/04

Ryland View 20/04/04

Ryland View 20/04/04

Ryland View 19/04/04

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Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Ryland View Arnhem Way Great Bridge West Midlands DY4 7HR Lead Inspector Amanda Hennessy Unannounced 20 April 2005 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 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. Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ryland View Address Arnhem Way Great Bridge West Midlands. DY4 7HR 0121 520 1577 0121 557 0859 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) BUPA Care Homes Care Home 140 Category(ies) of Dementia - over 65 years of age (60), Old age, registration, with number not falling within any other category (44), of places Physical disability (26), Terminally ill (10) Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: That 30 service users with Dementia (DE) 58 years and over will be accommodated on Heronville unit.- THis condition is met There will be two registered nurses on duty at all times between 09.00 to 21.00 hours on Bloomfield That 14 elderly (OP) service users and 10 service users with a terminal illness (TI) and TI(E) be accommodated on Bloomfield 30 service users with dementia DE(E) 58 years and older will be accommodated on Heronville. 30 service users with dementia DE(E) 58 years and older will be accommodated on Manby One service user identified in the variation application of the 29/11/04 may be accommodated on Manby who is 56 years and over. this will remain until such time that the identified service users placement is terminated and the home is able to meet her needs. 30 service users who are elderly and do not fall within any other category (OP) who are 58 years and older will be accommodated on Haines. Date of last inspection 18/1/05 Brief Description of the Service: Ryland View is a large home accomodating up to 140 service users within five separate, purpose built and spacious bungalows. The bungalows have each been named and are called Bloomfield, Haines, Manby, Palethorpe and Heronville. Bloomfield accommodates up to 24 residents who require continuing care, may require palliative care and who are 58 years old and above. Haines accommodates up to 30 elderly frail residents. Manby and Heronville each accommodate up to 30 elderly people who have dementia. All units can accommodate people with nursing needs. All bedrooms in each bungalow are single occupancy. There are four ensuite bedrooms on Bloomfield the remainder of bedrooms on all units have toilet and bathroom facilities close by. Each unit has a large communal lounge/dining room and small quiet lounge in addition both Bloomfield and Palethorpe have an additional lounge. Bloomfield also has a large meeting room that is frequently used for teaching sessions. There is also a small kitchenette on each unit where drinks and snacks can be prepared. There are a wide range of aids and adaptations such as grab rails, assisted baths, hoists available for people who need are dependent on each unit. A central laundry and kitchen are also situated in this in a separate block with the administartion offices. The home is situated off Arnhem Way, Tipton, has ample car parking and is accessible by car and public transport. Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken by three Inspectors. The time spent on the inspection included a tour of each unit, a review of records, care records were reviewed as part of the “case tracking” of recently admitted service users on three units, talking to service users, visitors, staff, and the Operations Manager. This was a positive inspection for Ryland View. Improvements in the risk assessments for bed rails, with the home ensuring that risk assessments, where appropriate are in place and completed and care documentation. What the service does well: What has improved since the last inspection? There has been a noticeable improvement in care records and care risk assessments including bed rails risk assessment on all units. Staffing levels have been increased on the afternoon shift on Haines. Policies and procedures for the safe keeping and administration of medicines on all units are addressing previous requirements made in respect to medicines. Statutory training that staff have received, and the way that it is recorded and monitored, was also noted to have improved at this inspection. Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 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. Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 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 standard(s) 3 The home has appropriate procedures to assess whether the home can meet prospective residents care needs prior to their admission. Social and leisure needs are not recorded in the prospective service users assessment of needs and therefore the home cannot demonstrate that it provides activities of the residents’ choice, need and capability. EVIDENCE: The Clinical Manager or another Senior Nurse on each unit undertakes a comprehensive assessment of the needs of all prospective service users prior to their admission to the Ryland View. Records of assessments for recently admitted service users to Heronville, Palethorpe and Bloomfiled were reviewed and generally meet the requirements of the regulations and identified the health needs of the person who was to be admitted. Staff do try to involve service users and their representatives whenever possible in an assessment of their needs although this is not recorded. One service user who had been admitted to Heronville in early April did not have a complete assessment of their needs with information such as their GPs name and address not identified, previous hospital admissions and their medication not recorded, it was unclear why this information was not available. The other area that was Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 Page 9 not recorded in the assessment of service users needs was their social and leisure interests, and therefore the home cannot demonstrate whether it can meet their need, choice and capability for social activities. It has been an unmet requirement since September 2002 that service users have an assessment of their social needs and a plan of care is in place to ensure that these are met. Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 9 Good progress has been made to improve care planning, risk assessments and procedures in relation to the safe keeping and safe administration of medicines. Good care records assist staff to identify and meet residents’ health care needs. EVIDENCE: There has been noticeable progress over the last twelve months to improve care planning, care risk assessments and particularly bed rail risk assessments to ensure that the health and personal care needs for all residents at Ryland View are planned for and met. A detailed plan of care was seen in every care file reviewed on each unit. Staff have obviously put considerable amount of time and effort to ensure that care plans are comprehensive and are regularly updated. It was pleasing to see on Heronville a record of review of audit of care plans by the Clinical Manager. Visitors spoken to said that they felt that they were informed of any changes in their relative’s health but were unsure of care planning processes. To ensure that development of care planning continues and the regulations are met staff must ensure that whenever possible there is a record that service users or their representatives are involved in the identification or review of care needs. It was identified that the dependency tool and the nutritional risk assessment Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 Page 11 that is used within the home do not identify the true dependency of service users and do not highlight the needs of all Ryland View residents such as those with dementia. Residents are usually weighed regularly however it was identified that sometimes residents with challenging needs refuse to be weighed and other new residents had not been weighed for several days (one resident was not weighed for a month after their admission). The nutritional tool therefore could not be accurately completed. Ryland View has a very low incidence of pressure sores with just three residents with pressure sores across the site. This is particularly noteworthy given the number and complex needs of Ryland View residents. It was pleasing to see the amount of specialist pressure relieving equipment that is available on all units, although consideration must be made to investment into additional pressure relieving cushions to further safe guard residents who are at very high risk of developing pressure sores and are able to sit in a chair. Care plans for the management of wounds and pressure sores reflect all requirements for the management and treatment of pressure sores. Photographs are available of all pressure sores to enable staff to effectively assess how well they are healing which is good practice. Staff do not always record when the pressure sore has been re dressed, one service user with a pressure sore on Manby had not had their care plan updated to identify that the pressure sore was infected and required antibiotics. The Commission for Social Care Inspection had not been informed of one service user who had a grade 4 pressure sore on Bloomfield. Care records demonstrated that there is good and timely liaison between staff at Ryland View and other health professionals in relation to residents’ health and well being. Records show that staff ensure that residents are regularly seen by Opticians, Dentists, Chiropodist and their GP. Health Professionals such as the Tissue Viability Nurse Specialist and Cancer Care Specialists speak highly about the care that is given at Ryland View. Policies and procedures in relation to the appropriate storage and safe administration of medicines at Ryland View are generally satisfactory and have improved since the previous inspection. The majority of previous requirements in relation to medicines had been met with the purchase of a new drugs fridge for Heronville and staff ensuring that the administration of all medicines including creams and lotions are signed for. Short life items such as eye drops and calgen did not have a date of opening on Bloomfield which is required. There is currently no consistency across the site in the way that the receipt of medication is recorded, in addition staff inaccurately check the receipt of medication against the previous medication administration record and not against the prescription as required. Copies of prescriptions were not always available as required should there be a requirement to review the medication that was prescribed for the resident. Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) No standards were assessed in this section. EVIDENCE: Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 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 standard(s) 18 There has been no progress on producing a vulnerable adults procedure to ensure a proper response to any suspicion or allegation of abuse. Staff have a poor knowledge of adult protection procedures and what constitutes abuse and therefore appropriate actions may not been taken to safeguard residents. EVIDENCE: Staff spoken to on all units were unclear about appropriate Adult Protection Procedures and would not take appropriate action if abuse was highlighted. Staff were also unclear about what constitutes abuse. There has been a requirement since September 2002 that the home’s Adult Protection policy is updated and links into the Local Authority Adult Protection policy, yet this has not been complied with. It is of particular concern that the current policy identifies that the home manager should undertake an investigation of any allegations of abuse, yet this may not be appropriate, in addition the current policy does not explore the need to contact other agencies. A recommendation made that a flow chart that identifies who staff should contact locally should an Adult Protection incident be highlighted has also not been undertaken. Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 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 standard(s) 19,20,22 There remain a number of outstanding requirements in relation to the decoration of the home and the availability of staff alert bleeps. The outstanding matters do not provide adequate safeguards and comfortable bedrooms for people living at the home. EVIDENCE: All units were visited and were found to be clean and free from any offensive odour. This is an achievement that Domestic staff should be proud of, especially given the challenging needs of some residents accommodated at Ryland View. Some of the home, and particularly the lounge and dining room on Manby, have been recently redecorated and refurbished and are very pleasant. There are a number of outstanding requirements in relation to the environment for Manby and Bloomfield and include marked walls and stained carpets and a requirement for a maintenance plan which has still not been fully addressed. Many bedrooms are pleasant, homely and bright with some having a patio door opening out on to a small patio. Families are able to bring in personal items to add homely touches to bedrooms. The marked walls, shabby soft furnishing together with the vinyl floors in other bedrooms (see additional Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 Page 15 requirement) must be addressed to ensure the otherwise positive attributes of the home are not overshadowed. There are extensive pleasant gardens around the home with access for people who have mobility problems. There is also a small safe enclosed area around Manby and Heronville which are the Dementia care units. All units are single storey with good and safe access for service users. Each unit has a range of aids and adaptations available for dependent people such as grab rails, specialist assisted baths, hoists and a small number of height adjusting beds available on each unit. There is a staff call system available which alerts staff to residents calling for attention by a bleep that staff carry. This bleep also alerts staff that a fire door has been opened or to the presence of a fire both for that unit or another unit on the Ryland View site. The availability of sufficient staff bleeps is crucial to protect the welfare of residents. It has been a requirement since February 2003 that at least four bleeps are available on each unit, however, this has never been met. At the time of the inspection there were: Heronville- 1 bleep available with 2 having been sent for repair Palethorpe- 2 bleeps available with 1 missing and staff were unaware of its location Manby – 3 bleeps available. Haines- 2 bleeps available with 1 having been sent away for repair Bloomfield- 2 bleeps available with 1 having been sent away for repair. An immediate requirement was issued that the home forward an action plan to identify their required number of bleeps to be available at all times with appropriate contingency arrangements to ensure that the number of bleeps is always available. Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 30 Service users needs are met by the number and skill mix of daytime staff available at the home. However, further review is required to ensure safe levels of care staff are available to meet service users needs on Manby and Heronville between 8 p.m. and 8 a.m. EVIDENCE: All units have the same shift pattern, 08.00–14.00, 14.00-20.00 and 20.0008.00. There is at least one qualified nurse on every unit twenty-four hours a day. Each unit’s off-duty rota was reviewed and are as follows: Haines accommodates 30 people who are elderly and frail it has 7 staff on the early shift, 5 staff on a late shift and 3 staff overnight. Since the previous inspection an additional member of staff is now on the late shift. Palethorpe accommodates 26 younger adults who have a physical disability. It has 7 staff on the early shift, 6 staff on the late shift and 4 staff overnight. Palethorpe also has extra nursing hours where nursing staff assist with care duties as required. Bloomfield accommodates up to 24 people of which 10 may have a terminal illness and the addition 14 may be older and require continuing care. It has 7 staff on the early shift, 5 staff on a late shift and 3 staff overnight. Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 Page 17 Manby accommodates up to 30 people with dementia. It has 7 staff on the early shift, 5 staff on a late shift and 3 staff overnight. Heronville accommodates up to 30 people with dementia. It has 6 staff on the early shift, 5 staff on a late shift and 3 staff overnight. The duty rota for Heronville identified that it was not easy to identify who was trained staff and who was care staff. The unit must also ensure that staff surnames are provided on the duty rota. Staff spoken to said that they felt that staffing levels on day duty did meet the needs of the residents however reservations were expressed about staffing levels on night duty for Manby and Heronvillle the dementia care units. People with dementia frequently have challenging needs such as wandering, violence and aggression. It has also been recognised, and is also identified within literature available on Heronville, that;“ people with advanced dementia (which both Heronville and Manby accommodate) can be more confused and agitated during late afternoon, evening and night. This is often referred to as the “sun-downing phenomenon”. There is a need to review the number of staff available during the evening and night to care for, supervise and meet the needs of the people accommodated on Heronville and Manby. Ryland View is progressing well towards the target of 50 of its care staff with their National Vocation level 2 qualification in care. When staff who are currently undertaking their qualification successfully complete the course the home will exceed the 50 target. New staff undertake an induction and then foundation training to National Training requirements. Staff are then encouraged to undertake their National Vocation level 2 qualification in care as soon as possible. Statutory training such as moving and handling, fire and basic food hygiene that staff are required to undertake is ongoing is recorded has been improved since the previous inspection. The way that statutory training is recorded has been improved since the previous inspection enabling senior staff to more easily identify training that is required. No staff that were on duty at the time on Heronville at the time of the inspection had received dementia awareness training as required. There is also a previous requirement that was originally made for Manby to ensure that all staff receive ethnic awareness training as the cultural needs of one gentleman were not being met. Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 36 and 38 The appointment of the new manager has resulted in positive developments in a number of key areas at Ryland View such as care documentation, medication, training and supervision. To ensure that she further safeguards Ryland View residents’ further development is required in policies and procedures in relation to the protection of vulnerable adults and addressing previous requirements. EVIDENCE: The Home Manager has been in post since the beginning of January 2005. She is an experienced Manager having previously managed another home and is also a qualified nurse. An application for Mrs Williams to be the registered manager of Ryland View has not yet been received by the Commission for Social Care Inspection. Supervision is well established across the Ryland View site with the majority of staff receiving bi-monthly supervision. The main omissions for supervision Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 Page 19 sessions are for night staff with some staff having not received any supervision since January 2005. It was pleasing to see that following a random inspection of residents files all residents who require bed rails have a completed comprehensive bed rail risk assessment in place. All reported earlier the home has good statutory training opportunities for fire safety training, moving and handling and basic food hygiene. The accident records were found to be appropriately completed. All accident forms are assessed by the Home Manager to ensure appropriate actions are undertaken to reduce the risk of further action which is good practice. There remains concern that the clinical waste bins are not locked despite an ongoing requirement. A previous requirement that portable appliance are tested has also not been met. The majority of portable appliances seen had no date label identifying when it was last tested or no test within the previous twelve months; the date label on one television was recorded as 10/10/98. Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 2 x x 2 x x x x STAFFING Standard No Score 27 2 28 2 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 1 2 x x x x 2 x 2 Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 Page 21 Are there any outstanding requirements from the last inspection? 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 24 Regulation 16(2) Requirement Provision of locks on all bedroom doors This was originally required for completion by June 2002 Partially met Locks are now available on the bedroom doors of residents on Manby, Palthorpe and Heronville The statement of purpose includes the following information: How the home is able to meet the needs of the client groups for which the home is registered; the most recent inspection report; complaints procedure and feedback from service users; the size of all bedrooms and communal rooms and other facilities available to residents. This requirement was made at the inspection undertaken in September 2002 Not assessed Terms and conditions of residency are given to all service users and are individualised identifying the room(s) that the service user will occupy and also identify what is covered by the Timescale for action 31/03/06 2. 1 4 31/03/06 3. 5 15(1b) 31/12/05 Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 Page 22 fee. This requirement was made at the inspection undertaken in September 2002 Not assessed at this inspection 4. 3 14(1b&c) The home must ensure that service users and their representatives are involved in the assessment of the service users needs and this is recorded in that assessment. Staff must ensure that the pre-admission assessment includes all areas identified by the National Minimum Standards for Older People This requirement was made at the inspection undertaken in September 2002 Partially met Need to record service user or their represen-tatives involvement in assess-ment New date 31/05/05 The registered person is able to demonstrate that they have confirmed in writing to the service user that having regard to the assessment the home is suitable to meet the needs of the service user in respect of his or her health and welfare. This requirement was made at the inspection undertaken in September 2002 31/05/05 5. 3 14(1d) 31/05/05 6. 7 15 The service user and or their 31/05/05 relative’s representatives are involved with the drawing up of the care plan and sign to confirm this and their agreement with the care plan. The residents social care needs are identified in the care plan. This requirement was made at the inspection undertaken in E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 Page 23 Ryland View September 2002 Record of involve-ment not seen Social care plans not available in the majority of care records seen New date 31/5/05 7. 8 15 All service users are weighed regularly as identified within their nutritional assessment. This requirement has been ongoing since the inspection undertaken in February 2003 Service users records seen identified that they were not all weighed regularly New date 31/5/05 31/05/05 8. 8 15 9. 9 13(2) 10. 18 13(6) Service users have the 31/05/05 appropriate pressure relieving equipment as identified by their pressure risk assessment. One person was not on a pressure relieving mattress as required within their care plan. One other mattress was alerting that it was operating at low pressure Both were addressed before the Inspector completed the inspection The home must ensure that: 31/05/05 The amount of medication received into the home is documented as well as the date, and the person receiving the medication must initial this. To expand the policies relating to 30/06/05 adult abuse, physical aggression and restraint to include references to the Local Authority multidisciplinary Protection of Vulnerable Adults Policy and procedures and to require the involvement of the National Care Standards Commission. This requirement was made at the inspection undertaken in September 2002 Version 1.30 Page 24 Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc This requirement was made at the inspection undertaken in September 2002 11. 19 16 & 23 The home has a recorded programme of routine maintenance and renewal of the fabric and redecoration of the home. This requirement was made at the inspection undertaken in September 2002 The maintenance programme addresses the marked walls in the following rooms (Bloomfield):7,10,19,40 and also the marked carpets in rooms 39 and 40,18,20,25,29 The damaged bath panel in bathroom 37 (Manby) is replaced. This requirement is outstanding since the inspection undertaken on the 6/5/04 The maintenance programme addresses the marked walls in the following rooms (Manby):12,14,18,20,25, this requirement is outstanding since the inspection undertaken on the 6/5/03 The home is assessed by a suitably qualified person who has a specialist knowledge of the client groups catered for, and provides evidence that recommended disability equipment has been secured or provided and environmental adaptations have been made to meet the needs of service users. This requirement was made at the inspection undertaken in September 2002 Not met for Palethorpe, Heronville or Haines New date 30/06/05 30/06/05 12. 19 16 & 23 30/06/05 13. 19 16 & 23 30/06/05 14. 19 16 & 23 30/06/05 15. 22 16 & 23 30/06/05 Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 Page 25 16. 22 16,23 Each unit has at least four (nurse 20/04/05 call) bleeps available at all times. This requirement has been ongoing since the inspection undertaken in February 2003. Not met 1 bleep available for Heronville 2 bleeps available for Palethorpe 3 bleeps available for Manby 2 bleeps available for Haines 2 bleeps available for Bloomfield To be addressed with immediate effect Clinical waste bins are kept locked at all times This requirement has been ongoing since the inspection undertaken in February 2003. The laundry policy identifies the temperature of each programme. Not assessed 20/04/05 17. 26 13(3) 18. 26 13(3) 30/06/05 19. 29 19 20. 30 18(1a) 21. 28 13 The home must ensure that if 30/06/05 the person supplying the reference is not the person identified upon the application form the reason for this is recorded. All staff files must contain a Criminal record check (CRB) form and birth certificate. This requirement was made following the inspection undertaken in NOvember 2003 Not assessed. All staff (Manby and Heronville) 01/05/05 receive dementia care awareness training. This requirement was made following the inspection undertaken in January 2005 and must be addressed by the 1/5/05 Partially met The home must forward a copy 01/05/05 of its Landlords Gas Safety Version 1.30 Page 26 Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc 22. 38 13(4) 23(2) 23. 35 Sch 4(9) certificate and 5 year wiring certificate. This requirement has been ongoing since the inspection undertaken in November 2003. Not met The home must ensure that all PAT tests are performed annually. This requirement was made following the inspection in January 2005 and should have been completed by 1/4/05 Partially met The registered person must ensure that when a number of receipts are handed over at one time by relatives that: the total balance of the receipts is calculated, the receipts are numbered and the date recorded when the transaction took place. receipts are filed in the appropriate envelope Not assessed 31/05/05 31/05/05 24. 9 13(2) 25. 16 22 The home must ensure that all 20/04/05 medication is labelled and the date for opening documented. (Bloomfield) This requirement was made following the inspection in January 2005 and should have been completed by 1/4/05 The registered individuals must 31/05/05 ensure that a record of complaints is kept which evidence the investigations undertaken and that the complainant has been informed of what action is /has been taken within 28 days Not assessed. This requirement was made following the inspection in January 2005 and should have been completed by 1/4/05 Version 1.30 Page 27 Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc 26. 26 13(3) 27. 8 13(b) 16(k) 28. 8 19(5) 29. 8 37 30. 31. 9 19 13(6) 23 32. 22 23 The registered individual must ensure that: commode racks are purchased for both sluices. Linen skips are not overloaded. This requirement was made following the inspection in January 2005 and should have been completed by 1/3/05 Partially met Commode racks have not been replaced New date 30/06/05 The registered persons must gain specialist advice regarding the continence management of service users (Manby) Not assesses. This requirement was made following the inspection in January 2005 and should have been completed by 28/2/05 All staff have training on pressure sores and their prevention and the effective use of pressure relieving equipment. All factors that affect the health and well being of service users are reported to the Commission for Social Care Inspection. All staff receive training in the Protection of Vulnerable Adults (Bloomfield) The stained carpets in rooms 10 are effectvely steam cleaned to remove the staining or are replaced. Partially met. The broken bath panel in bathrooms 16 and the loose bath panel in bathroom 20 is fixed securely. An action plan is forwarded to the Commission for Social Care Inspection that identifies the number of bleeps required at all times and appropriate contingency arrangments to ensure that number of bleeps are always available. 30/06/05 31/05/05 31/07/05 20/04/05 31/07/05 31/07/05 31/07/05 Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 Page 28 33. 27 23 34. 27 18 35. 36. 37. 38. 39. 31 9 The staff duty rota identifies qualified and unqualified and the full name of the member of staff on duty. A review is undertaken to ensure that there are sufficient staff available to meet residents needs on both Heronville and Manby during the evening and night. An application is received for the Manager to be registered manager of Ryland View. 20/04/05 20/04/05 15/05/05 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. 4. Refer to Standard 24 18 8 8 Good Practice Recommendations Height adjustable beds for all residents requiring nursing care whilst they are in bed. A flowchart is available to assist staff to understand and access Adult Abuse procedures. Additional pressure relieving cushions are available The depenedency tool that is used throughout the home is reviewed to ensure that the depenednecy of people that the home accommodates is appropriately identified Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 Page 29 Commission for Social Care Inspection West Point Mucklow Office Park Mucklow Hill Halesowen. B62 8DA 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 Ryland View E55 S4818 Ryland View V222047 19 200405 Stage 42.doc Version 1.30 Page 30 - 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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