Inspection on 07/06/05 for Ryton Towers

This inspection was carried out on 7th June 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ryton Towers 06/08/07

Ryton Towers 01/08/06

Ryton Towers 22/09/05

Ryton Towers 11/01/05

Ryton Towers 23/07/04

Ryton Towers 04/03/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Ryton Towers Whitewell Lane Ryton Tyne Wear NE40 3PG Lead Inspector Steve Tuck Unannounced 7 June 2005 at 10.00 am 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. Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Ryton Towers Address Whitewell Lane Ryton Tyne and Wear NE40 3PG 0191 413 8518 0191 413 8518 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) Wellburn Care Homes Limited Care Home 43 Category(ies) of OP Old Age (43) registration, with number DE(E) Dementia over 65 (10) of places PD(E) Physical Disability over 65 (6) SI(E) Sensory Impairment (2) Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 11 January 2005 Brief Description of the Service: Ryton Towers is a care home which can provide personal care for 43 people who are older, ten of whom may have dementia, six may have a physical disability, and two may have a sensory impairment. The home also provides respite care. The home cannot provide nursing care. The home is a two-storey building, located in the village of Ryton and is set in its own grounds adjacent to the local park. The home is within close proximity to a variety of local village facilities and is serviced by regular public transport. There is a lift provided which enables service users to get to and from the first floor. An emergency call system is provided in all individual bedrooms, bathrooms and communal areas. Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 5 hours and was a scheduled unannounced inspection. The inspection process involved spending time talking to a number of the people who live in the home as well as the manager and staff. A sample of records were examined including care plans and rotas. A tour of the building took place, which included all communal areas and a selection of service users bedrooms. Service users were joined for lunch and observations were made of the support the staff offered to service users at lunchtime and throughout the day. Discussion also took place with visitors to the home including friends, relatives and healthcare staff. The judgements made are based on the evidence available on the day of the inspection. What the service does well: What has improved since the last inspection? All service users now have assessments completed prior to moving to the home so that the manager and staff can agree with them the best ways in which to give them support. Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 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. Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 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 Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 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) 1 3 and 6 A range of information is available which enables service users to make a fully informed choice about where they would like to live. Each service user’s needs are assessed prior to their move to the home and periodically thereafter. This will help ensure that each service user’s needs are met at the home and inappropriate admissions avoided. The service does not provide intermediate care. EVIDENCE: The service user guide is used by the manager to provide potential customers and their relatives with easily understandable information on the facilities available to them at the home. This includes information about how to make a complaint. All service users and their relatives who were spoken to said they had seen this booklet. Each service user has a social worker’s assessment undertaken prior to their admission to the home. The manager also carries out an individual assessment, to ensure that the home is suitable for meeting the needs of service users who are accommodated there. Records indicate that the manager has also involved other health and social care personnel where specialist assessment has been required. Records Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 Page 9 indicate that service users and their representative are fully involved whilst carrying out the assessment and any limitations or restrictions are agreed. Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 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 9 and 10 The measures staff take to support the health and personal care needs of service users is not fully recorded in the individual plan of care therefore making it difficult for staff to consistently meet their needs. The homes procedures for storing and administering medication are not sufficiently robust to safeguard service users. The physical and emotional needs of service users are supported by the home to ensure that they remain as active as possible. Staff have a friendly and respectful approach towards service users, which empowers them and gives them control over their lives. EVIDENCE: A random sample of service users’ records were examined which indicated that service user plans do not yet adequately describe the actual support and intervention which staff are currently carrying out. Staff practices demonstrated that they have well thought out ways in which they support service users, For example staff have specific responses they use with one Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 Page 11 service user with dementia type symptoms which help her from being distressed. Also staff practices to support service users with some key areas of need for example diabetes or hearing loss, were observed. However care plans did not include specific instruction about how these needs were to be met. Relatives, service users and a visiting nurse confirmed that the home supports those resident at the home to remain healthy. This involves promotion of a healthy lifestyle, for example: a balanced diet and taking regular exercise as well as the involvement of professional health care services when this is required. Despite work undertaken by senior staff, medication procedures at the home could not be successfully used to carry out a sample audit of the medication held there. There were also a number of omissions in the administration record which meant that it was impossible to tell whether service users had received their medication or not. Staff were observed to treat service users who took part in discussions with respect and service users described staff as ‘very patient and understanding’. Relatives said that staff are ‘caring and friendly’ and give ‘fantastic’ support to service users. Staff were observed to have a good interaction with service users and their visitors. Several service users commented that staff have time to sit and talk to them. Staff talked about service users’ needs in a sensitive and respectful way. Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 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) 12 13 and 15 A selection of social activities both in and outside of the home are provided enabling service users to make positive choices about how they spend their day and friends and families are encouraged and involved too. The meals provided offer a good balanced diet and contribute to the promotion of healthy eating and service users are involved in menu planning. EVIDENCE: Discussions with the manager and observations made during the inspection indicate that activities are provided within the home. Some service users are encouraged to continue to engage in social activities within the community often with the support of family or friends. A variety of activities are available to service users including, meals out, baking sessions, painting, pamper days, flower arranging and keep fit. One service user has been supported to continue his interest in entertaining much to the delight of other service users. Relatives and service users commented about how they liked these activities because it gave them something to look forward to. Service users said that they like the meals at the home and that they are asked what they would like to eat. Staff were observed asking service users about their choice of meal, size of portion to ensure that the element of choice for service users is always followed. Staff were available during the meal to Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 Page 13 offer support and assistance where needed and this made the meal time a relaxed and unhurried experience for service users. Menus were available which confirmed that a good range of meals and refreshments are provided to service users and the manager reports that these have been discussed with a nutritional expert to ensure that they provide service users with a balanced diet. Where necessary and as identified in the individual assessment, special diets and food supplements are made available and, as part of an ongoing process of monitoring health, records of weight loss/gain are recorded in service users’ files. Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Complaints in the home are handled objectively and openly and the manager and staff encourage service users, their friends and families to offer comment on the services that are offered so that further improvements can be made. Robust procedures are also in place, which ensure that service users are protected from abuse. EVIDENCE: Service users and their relatives commented that they are confident that any complaints made would be acted upon. The manager and owner continue to encourage service users and their relatives to express their views and opinions about the service and can demonstrate instances where actions have been taken in response to service user preferences. All service users have a copy of the home’s complaints procedure, which is available in each room. Discussions with service users and relatives indicate that they have no complaints at present but would approach the manager if this occurred and feel confident that she would act on this immediately. The service uses a set of procedures known as POVA (Protection of Vulnerable Adults) to offer protection to service users and previous experience of the service has demonstrated that these procedures are adhered to and work effectively. Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 Page 15 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) 21 and 26 The building is clean, warm, homely and attractive offering service users a pleasant environment in which to live but this is compromised by hot water temperatures in bathroom facilities, which are unsafe for them to use. EVIDENCE: All communal areas and some service users bedrooms were viewed during the inspection. Some of the service user bedrooms have been redecorated and refurbished since the last inspection and a programme of routine maintenance and replacement is in operation. Service users spoken to said that they liked their rooms, some of which have been individually decorated to reflect their lifestyles, tastes and interests. The water in one bathroom was too hot to touch therefore placing service users at risk of scalding. An Immediate Action Notice was issued to the manager for her urgent attention. The home has a fully equipped laundry where systems are in place to ensure that clothes are hygienically cleaned. Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 Page 16 The manager has confirmed in writing to the Commission for Social Care Inspection that all issues identified during the fire authority inspection have been addressed. Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 Page 17 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 and 29 The deployment and number of staff on all shifts ensures that at all times service users are supported by an experienced group of staff. Staff recruitment practice does not protect service users and record keeping in respect of new staff employed in the home, is not robust and does not offer sufficient information to ensure that service users are protected. EVIDENCE: Although there were a number of unexpected staff absences, the manager had ensured that sufficient staff were available to meet the needs of service users at the home. The recruitment of a team of staff who are available at short notice has improved this substantially. Examination of a sample of staff records and confirmation by the manager indicated that staff had been employed by the agency without sufficient background checks having been carried out which would determine their suitability to carry out their role. Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 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) 33 36 and 38 Service users are asked by the organisation and by staff about how they want their support to be provided so that their rights and best interests are promoted. The manager ensures that all staff have guidance and support so that service users needs can be most effectively met. Arrangements to ensure that the health safety and welfare of service users and staff are in place and are usually successful. EVIDENCE: The provider organisation gathers the views of service users and uses this information to improve the way that the service is provided. The views of service users and their families are sought by carrying out formal research. All information is used to ascertain how well the home is working, and to make changes to improve the lifestyle of people who live at Ryton Towers. Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 Page 19 Records show that staff receive regular supervision at least six times per year and appraisals, which help to develop their skills and promote good, care practices with which they can effectively meet service users needs. The manager can also demonstrate the safeguards to reduce the risk of accident or injury to service users and staff. These include for example, ensuring that sufficient staff have undertaken first aid training. Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 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 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x 2 x x x x 3 STAFFING Standard No Score 27 3 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x 3 x 3 Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 Page 21 YES 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 7 Regulation 15 Requirement Service user plans must be developed to include detailed instructions of the interventions necessary to meet service users needs. (Previous timescale1.5.05) The manager must ensure that records accurately reflect the levels of medication held and administered at the home.(Previous timescale 1.4.05) Medication records must match the stock of medicines held.(Previous timescale 15.2.05) The manager must ensure that water temperatures are safe for service users to use without injury. A satisfactory Criminal Records Bureau check must be carried out before any staff can take up their positions at the home.(Previous timescale 15.2.05) Timescale for action 1/9/05 2. 9 13 15/8/05 3. 9 13 15/8/05 4. 21 13 7/6/05 5. 29 19 1/8/05 Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 Page 22 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 Good Practice Recommendations Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Baltic House Port of Tyne South Shields Tyne and Wear NE34 9PT 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 Ryton Towers B52-B02 S7432Ryton Towers V219304 070605 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!