Inspection on 22/11/06 for Rylands

This inspection was carried out on 22nd November 2006.

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

Rylands 28/11/05

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Rylands 74 Forton Road Newport Shropshire TF10 8BT Lead Inspector Janet Oxley Key Unannounced Inspection 22nd November 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rylands Address 74 Forton Road Newport Shropshire TF10 8BT 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) 01952 814871 01952 825536 Rylands Care Limited Tracie Deborah Peate Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home must provide the following minimum staffing levels for 34 service users: 8am-2pm - 2 RNs and 6 Care Assistants: 2pm-8pm - 2 RNs and 6 Care Assistants: 8pm-8am - 1 RN and 3 Care Assistants. These are minimum levels required throughout the 24hr day, including weekends, for service users who have low to medium dependency nursing needs. Additional staff must be on duty when high dependency service users are accommodated. These minimum levels are for direct nursing and personal care only. They do not include ancillary staff. They are exclusive of the manager`s time. 28th November 2005 Date of last inspection Brief Description of the Service: The Rylands is a care home offering both personal and nursing care to older people. The Home is registered to provide care for a maximum of 34 clients requiring nursing care. Rylands is owned by Rylands Care Limited, the Responsible Individual being Dr Mark Cowling and the Manager is Ms Tracie Peate. The Home is a large, converted country house with accommodation provided on three floors. Communal lounges and dining rooms are situated on the ground floor with bedrooms on all three floors. Residents requiring nursing care are usually accommodated on the ground floor, although those who are sufficiently mobile may have a room on the first floor. The two upper floors are accessed via a shaft lift or stairs. The gardens are well kept and accessible to the Residents. The home makes their services known to prospective service users in: The Statement of Purpose, Service User Guide and web site which also contain their contact e mail address. The inspection report is mentioned in the statement of purpose and summarised in the service user guide. It is also on display in the entrance hall. Fees are reviewed annually and range from £399 - £584. The only additional charges to service users are for hairdressing, some cosmetics and newspapers. This is clearly laid out in the terms and conditions. Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: information from the provider, looking at relevant records pertaining to key standards, chats with residents, a visiting county trainer, discussions with staff on duty and 2 visitors, discussions with the Manager, tour of the premises, previous inspection reports, quality assurance process, Fire Authority reports, Environmental Health Office reports and observation of care experienced by people using the service. What the service does well: What has improved since the last inspection? Requirements made at the last inspection have been complied with or are in hand. The Proprietors, Manager and staff continue to regularly improve the environment and since the last inspection a number of areas have again been re-decorated and refurbished. All recording systems are reviewed, amended and updated on a regular basis and it has to be noted that at this home the Proprietors and Manager are reviewing all aspects of the service to achieve best practice and maintain a high quality service. Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2, 3, 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The policies and procedures that are in place, and have been professionally followed, ensure that the home undertakes all necessary assessments for successful and satisfactory admissions to take place. EVIDENCE: The home has a Statement of Purpose and a Service Users Guide, which includes all the required information for prospective residents. These documents are currently under review to improve and expand on the information. Documentation examined indicated that individuals have a full and comprehensive assessment of their needs prior to admission, which is reviewed and amended as requirements change. Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 9 Discussions with residents, the manager and staff on duty indicated that the home continues to meet the individual needs of the elderly people living at the home in a professional and sensitive manner. Significant time and effort is spent making each admission to the home personal and effective and family members and the prospective service user may visit the home as often as they wish until a decision is made. On the day of this inspection one resident was admitted and he and his wife were complimentary regarding the process. Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8,9 and 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health and personal needs of service users are very well met with evidence of regular review and of good multi disciplinary working taking place on a regular basis. EVIDENCE: Personal and healthcare support in this home is offered in such a way as to promote and protect service users’ dignity and privacy in their daily life and at the end of life. It was evident during the inspection from looking at records, inspecting the facilities and chatting to staff and residents that individual health, personal and social care needs were being met. The manner in which the care plans are maintained, continue to be developed and the professional way in which they promote the importance of the compatibility of the service user and their plan is good. Personal care monitoring is undertaken on a regular basis to ensure that staff are following Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 11 the care plans and that the residents are all getting a good quality of care. Also worthy of note is the manner in which the manager and staff monitor and promote the residents psychological health to ensure that they are happy and content and they fully promote their rights as individuals. Residents were being treated with respect and staff were working both professionally and sensitively in meeting individual needs. Those residents spoken to were complimentary regarding the quality of their lives at the home and visiting health professionals praise the management and care standards there. Those residents being nursed in bed looked extremely comfortable and well cared for. Medication appears to be stored, recorded and administered satisfactorily and relevant staff have received the necessary training. Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All standards. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The routines of daily living at The Rylands are very flexible and each resident finds the lifestyle experienced in the home meets their individual needs. Many activities take place, there is an open visiting policy and the menu offers a choice of well balanced and wholesome meals. EVIDENCE: The residents are encouraged and enabled to personalise their bedrooms and have a number of activities arranged for them within the home and outside. These activities are publicised in the front hall and on individual calendars. Individual needs, likes and dislikes are clearly shown in the care plans and the activities residents participate in are recorded and discussed at client focuses meetings. Activities also take place with the help of the ‘Friends of the Rylands’ who organise events as flower arranging, beauty therapy and clothes sales. Menus, the meal seen and tasted and discussions indicated that a good diet was on offer and that the catering arrangements were satisfactory. Staff were seen to support the more frail residents to eat their meal in a sensitive and professional manner and the dining areas are pleasant with well laid tables. At Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 13 the time of the most recent Environmental Health Officers visit it was considered that the food safety management system was good. Residents are certainly enabled to exercise choice and control over their own lives as far as they are able and there is a good range of information at the home for residents and visitors including aspects of advocacy and legal and financial matters. Visitors are always made welcome, are included in events and are given all the necessary information on aspects of the home and the welfare of the residents. Visitors spoken to have been complimentary regarding the care the residents receive at the home and many thank you letters were displayed in the front hall. Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Concerns and complaints are dealt with promptly and professionally and robust procedures and practices are in place to ensure that individuals are protected from abuse. EVIDENCE: The home has a clear complaints procedure, which is given to residents and their relatives before they move into the home and which is on display in the front hall. No complaints have been received since the last inspection by the home or CSCI. This is considered to be as a result of lack of incidents rather than lack of understanding when incidents should be reported. Residents and others associated with the home state that they are extremely satisfied with the service, feel very safe and well supported by the resident proprietors and staff. Residents and their families are also consulted about the services received through regular questionnaires and regular reviews. Outcomes from the surveys are publicised. Adult protection procedures are in place. Staff are made fully aware of these procedures. Training for new staff is arranged as necessary without delay. The home has a copy of the current Shropshire County Council Multi Agency Adult Protection Procedure, the manager has undertaken training for managers, Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 15 there is good liaison with other professionals and 1 POVA referral has been professionally acted upon and policies and procedures carried out to the full. Minor concerns, received by staff at the home, from residents, are dealt with in a professional manner without delay and it was evident that management and staff respect, observe and listen to the residents. Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20, 23 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the home is generally good, providing service users with a warm, safe and homely place to live. Necessary improvements have been identified and are in hand. EVIDENCE: The location and layout of the home are suitable for elderly residents. Communal rooms are well equipped and are warm, homely and welcoming. Bedrooms are personalised and suit individual needs and the gardens are attractive and there is a patio area with seating, easily accessible to residents and their visitors. Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 17 At the time of the most recent Fire Officer and Environmental Health Officer’s inspections matters were reported to be satisfactory and advice given has been acted upon. It was evident that the manager and staff work hard to maintain a pleasant environment and further improvements, including an extension, improved communal and storage space, refitted kitchen and a new lift are planned At the time of this inspection the standard of hygiene and cleanliness was good. Following a full infection control audit suggestions have been complied with, the manager has completed a course at Staffordshire University and all staff have received training on the subject Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All standards. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported by a well trained and committed staff group who are meeting the needs of each individual in a sensitive and professional manner. EVIDENCE: The rotas, ratios of staff on duty at the time of inspection and the number of domestic, laundry, maintenance and administrative staff employed indicates that the home exceeds the laid down staff complement. Recruitment at the home is thorough and all elements required by Schedule 2 of the Care Home Regulations are maintained on file. The files of 2 newly recruited staff were seen to be satisfactory and staff members were very complimentary regarding the support and supervision they receive and the management and care practices at the home. Staff turnover is fairly low, agency staff are rarely used and the manager is vigilant in her efforts to ensure that suitable staff are employed to care for the service users The arrangements for ongoing training and foundation training are good with staff completing these well within the required time. The home continues to support staff to undertake their NVQ awards, more than 60 of care staff have achieved NVQ level 2, 7 staff have completed the NVQ level 3 and 3 have commenced the NVQ level 3, a good variety of other Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 19 training has been undertaken and staff on duty indicated that they were very sensitive to the residents needs and disabilities and that their attitudes and practice were monitored and supervised by the proprietors. Recorded staff supervision, staff meetings and appraisals are undertaken in a professional manner and training records are maintained for each staff member. Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 35 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are clear lines of accountability within the homes management structure and the management approach creates an open and positive atmosphere from which the residents benefit. The home reviews all aspects of its performance through a programme of self review, questionnaires and consultations and meets the requirements of the Fire Officer and Environmental Health Officer, promoting the health, safety and welfare of the residents. Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 21 EVIDENCE: The registered manager, is fully qualified, has many years experience and carries out her responsibilities fully with sound leadership skills promoting a professional ethos within the home. It is evident that she continues to update her own professional knowledge by attending a number of related courses to the resident group catered for. The owner (S Cowling) and the Deputy Matron are undertaking the Registered Managers Award. The manager involves herself fully in the day-to-day running of the home and can relate to all matters pertaining to the National Minimum Standards. The manager was complimentary regarding the support she has from the proprietors and how all were planning to meet in the near future with an external professional to define management roles. The manner in which the manager and staff responded to this inspection indicated that a sound management approach is in place and that staff are committed to achieving best practice and to developing equal opportunities. Equality and diversity for the service users were seen to be promoted throughout the home, within the assessments, care plans and activities. Equality for staff is promoted through opportunities for training at all levels. As previously mentioned at the time of the most recent Fire Officers and Environmental Health Officers inspections matters were satisfactory and recommendations made have been complied with. The manager is receiving professional support and has commenced on a full Fire Safety Risk Assessment for the home. Sound quality assurance systems are in place and there was evidence available to indicate the manager ensures, so far as is reasonably practical, the health, safety and welfare of service users and staff. All staff have attended health and safety training and relevant mandatory training was reported to be up to date or booked for the near future. At the time of this inspection no potential hazards were identified and all records required are maintained in a professional manner. The accident records were satisfactory and it was reported that a first aider is on site at all times. Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 x x 3 x x 3 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 x 3 x x 3 Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Rylands DS0000064650.V297399.R01.S.doc Version 5.2 Page 25 - 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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