This inspection was carried out on 4th October 2005.
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.
CARE HOMES FOR OLDER PEOPLE
Rylands Care Home Rylands Residential Home 9-11 Meadows Road Beeston Nottingham NG9 1JP Lead Inspector
Sharon Rosenfeld Unannounced Inspection 4th October 2005 14:30 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 Care Home DS0000008795.V254576.R01.S.doc Version 5.0 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 Care Home DS0000008795.V254576.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Rylands Care Home Address Rylands Residential Home 9-11 Meadows Road Beeston Nottingham NG9 1JP 0115 9436247 0115 9436247 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) Mr Vijay Mehan Mrs Mandy Jeannette Wilkinson Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Rylands Care Home DS0000008795.V254576.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 25th May 2005 Brief Description of the Service: Rylands Care Home is situated close to the centre of Beeston, which provides a good variety of local facilities and amenities. The accommodation is sited over three floors, with the service users accommodation on the ground and first floor. There is a passenger lift providing access to all levels. The home is comfortably furnished and has been decorated and maintained to a very good standard. The rear garden was redesigned last year and now provides a private and very pleasant environment for service users. Rylands Care Home DS0000008795.V254576.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was the second of two unannounced inspections to be carried out between April 2005 and March 2006. The inspection was undertaken in approximately two hours and the main focus of the inspection was the assessment of key standards not met or not assessed at the previous inspection. Discussions were held with four residents, two staff and the manager. A range of records were examined. The premises were not fully inspected. Those areas visited were clean and well ordered. There were no mal-odours and the home was welcoming, warm and inviting. One person said they were happy with their accommodation. What the service does well:
The manager has the confidence of the residents and the staff. One resident said the manager understands his care needs and is very well organised. Two residents said they were happy living at the home and were satisfied with the services provided. There is involvement with local advocate groups who facilitate meetings with residents on a regular basis. The Registered Manager receives minutes of these meetings which she then responds to in writing. Records of these meetings are kept in the lounge for everyone to access. It is clear from the records that changes to daily routines have been implemented following this consultation with residents and this is good practice. The service continues to develop and evolve. Positive and open working relationships were observed between the management and staff. The expectations of staff are clearly defined. The staff team are accessing training and supervision, this was a requirement of the last inspection. The owner of the home visits on a regular basis and takes a keen interest in the well-being of the residents. Rylands Care Home DS0000008795.V254576.R01.S.doc Version 5.0 Page 6 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. Rylands Care Home DS0000008795.V254576.R01.S.doc Version 5.0 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 Care Home DS0000008795.V254576.R01.S.doc Version 5.0 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 the following standard(s): These standards were found to be met or exceeded at the previous inspection and therefore were not assessed on this inspection. EVIDENCE: Rylands Care Home DS0000008795.V254576.R01.S.doc Version 5.0 Page 9 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): These standards were found to be met at the previous inspection and therefore were not assessed on this inspection. EVIDENCE: Rylands Care Home DS0000008795.V254576.R01.S.doc Version 5.0 Page 10 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): These standards were found to be met or exceeded at the previous inspection and therefore were not assessed on this inspection. EVIDENCE: Rylands Care Home DS0000008795.V254576.R01.S.doc Version 5.0 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): These standards were found to be met at the previous inspection and therefore were not assessed on this inspection. EVIDENCE: Rylands Care Home DS0000008795.V254576.R01.S.doc Version 5.0 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): These standards were found to be met or exceeded at the previous inspection and therefore were not assessed on this inspection. EVIDENCE: Rylands Care Home DS0000008795.V254576.R01.S.doc Version 5.0 Page 13 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): 30 The staff are trained and competent to do their jobs. Recruitment practice does not always comply with current requirements. EVIDENCE: Of the fourteen staff employed at the home seven are registered to undertake their NVQ training at level II. Two staff have already achieved their NVQ II and one staff member has achieved NVQ level III. The home is registered with the local college for the delivery of this training. All staff have undertaken the intermediate level of the Principles and Practice of Care. All staff have undertaken training in the following areas: First Aid; Moving and Handling; Infection Control; Health and Safety; Safe Handling of Medicines and Fire safety. Evidence of staff putting their training into practice was observed. They were confident when assisting residents to move and interacted with residents in a professional but friendly way. The Registered Manager is undertaking training to ensure her continuous professional development. The Criminal Records Bureau (CRB) Enhanced Disclosure is not portable between jobs in all circumstances. The Registered Manager must familiarise herself with the requirements regarding CRB’s to ensure the home has a robust recruitment procedure.
Rylands Care Home DS0000008795.V254576.R01.S.doc Version 5.0 Page 14 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): 33, 36. The home is managed in the resident’s best interests. The staff receive appropriate supervision. EVIDENCE: The owner of the home visits everyday and takes a keen interest in the wellbeing of the residents. These visits are not recorded in accordance with regulation 26 of the Care Homes Regulations 2001 The Rylands is working toward the Investors in People Award. To monitor and measure the quality of the service, questionnaires have recently been sent to all residents and their representatives. The responses were only just beginning to arrive back and therefore they have not yet been analysed. Rylands Care Home DS0000008795.V254576.R01.S.doc Version 5.0 Page 15 The residents have opportunities to meet regularly with local advocates. Comments are made to the Registered Manager through the advocate who then responds in writing. A number of changes have been made to the daily routines at the home since this process began. This is very good practice. The formal supervision of staff on a one to one basis is continuing to develop. A number of the staff are not accustomed to this method of support however, the Registered Manager and senior staff are continuing to promote this and are receiving training in supervisory skills. Rylands Care Home DS0000008795.V254576.R01.S.doc Version 5.0 Page 16 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 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 2 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 4 X X 3 X X Rylands Care Home DS0000008795.V254576.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation 19 Requirement The Registered Manager must not appoint a staff member to commence work without a PoVA first check or an up to date CRB enhanced disclosure. Timescale for action 02/11/05 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 Refer to Standard OP33 Good Practice Recommendations It is recommended that the provider use one of the CSCI’s Regulation 26 forms to ensure compliance with this regulation. Rylands Care Home DS0000008795.V254576.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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