Inspection on 13/05/05 for The Raikes

This inspection was carried out on 13th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Raikes 20/08/09

The Raikes 07/06/07

The Raikes 08/06/06

The Raikes 01/11/05

The Raikes 16/11/04

The Raikes 08/06/04

Similar services:

Snydale Care Home

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Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Staveley Birk Leas Nursing Home

Carentan House

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

CARE HOMES FOR OLDER PEOPLE The Raikes Bradley Road Silsden Keighley BD20 9JN Lead Inspector Carol Haj-Najafi Unannounced 13 May 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. The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Raikes Address Bradley Road Silsden Keighley BD20 9JN 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) 01535 653339 01535 653952 Crabtree Care Homes Mrs Catherine Lynch Care Home Only 31 Category(ies) of Old Age (18) Physical Disability Over 65 (10) registration, with number Dementia Over 65 (4) of places The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16th November 2004 Brief Description of the Service: The Raikes is a detached property on the outskirts of Silsden, halfway between the towns of Keighley and Skipton. The home is set in attractive gardens with views across the surrounding countryside.The Raikes is part of a group of homes owned by Crabtree Care Homes. The home is registered to provide personal care for up to 31 older people. Accommodation is provided in single and twin rooms on the ground and first floor. There are three lounges and a dining room. Two passenger lifts provides access to the first floor. A parking area is provided to the side of the property. The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this unannounced inspection on 13th May 2005. The inspection started at 9.45am and finished at 5.00pm. The inspector spoke to several residents, visitors, staff members, and the registered manager. A tour of the building was completed, and records were inspected, which included resident’s care plans, meeting minutes, accident records, monitoring reports, and menus. What the service does well: What has improved since the last inspection? What they could do better: The home must improve their recording systems, as some important information is missing. Service user plans must contain more information and be properly updated. Residents are not given enough information about the home before they move in; the information should have been produced after the last inspection but it is still not available. Unacceptable medication practices were seen at the inspection, which could pose a risk to the residents at the home. Staff and the manager need to be more aware of adult protection procedures including reporting matters to other agencies. Requirements and recommendations identified at this inspection can be found at the end of this report. The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.doc Version 1.30 Page 6 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 Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.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 The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.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) 1, 3, 4 Resident’s needs are assessed before they move in but the written assessments do not contain enough information, which could result in a residents’ needs not being met. Residents are told about the home but they do not receive any written information, which would assist them to make an informed choice about the home. EVIDENCE: A resident who recently moved into the home said before she moved in someone visited her at the hospital and talked about the help she needed and the home but she did not receive a brochure or any written information. The manager confirmed that she always completes a pre-admission assessment and visits the person. Service user guides are not available, and the statement of purpose is waiting to be updated. The home had obtained a lot of information about one resident who was moving from a different part of the country and social work assessments had been obtained for other recent admissions. Pre admission assessments that had been completed by the home for other service users did not contain sufficient information in terms of risk management, personal care needs and likes and dislikes. The home does not provide intermediate care. The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.doc Version 1.30 Page 9 The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.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 & 9 The standard of service user plans is poor. They do not identify how resident’s needs should be met and are not effective working documents, as a result staff are unsure how some residents should be cared for. Proper medication systems are in place but are not followed in practice creating a high risk of medication error. EVIDENCE: The inspector looked at three service user plans. One resident that was admitted in March 2005 did not have a care plan or any risk assessments, and another service user who was admitted in February only had basic information recorded. No guidance was available for staff to help a service user whose care needs have changed dramatically over the past few months. Staff said they did not know how they could best meet the resident’s needs. Some information recorded conflicted with other written information. Staff said they do not access service user plans on a regular basis. The home uses a monitored dosage medication system, and medication is well organised. However, the medicines trolley was open when the inspector arrived although no staff were in the vicinity. A staff member administered the lunchtime medication but a different person who was not present during the The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.doc Version 1.30 Page 11 administration of the medication signed the medication administration records; this practice does not comply with the home’s procedures. The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.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) 12, 13. 14 & 15 Family and friends are encouraged to visit the home and made to feel very welcome. The communication between staff and relatives is good, and relatives are comfortable in approaching staff and management to discuss any concerns they may have. Group activities are provided but improvements could be made. The meals served are good and residents are happy with them although they do not know what they are having until it is served. EVIDENCE: The inspector spoke to five relatives, all of whom were very positive about the home, staff and manager. Relatives said they were always made welcome, informed about any issues or concerns and the staff were always friendly. Only one concern regarding the wrong clothing being put in wardrobes was raised. Residents said ‘it’s nice here and the staff are very good’. Residents are encouraged to put forward suggestions for meals and activities at resident’s meetings. Afternoon group activities are organised by staff at the home, one resident spoke of the activities and said she enjoyed them. Some residents spend a lot of time in their rooms; one resident said they don’t get chance to talk to staff because they are always busy. Three residents are starting to attend a weekly local community club; one resident said she was very pleased to be going. A suggestion was put forward to employ an activities worker at the home to improve activities; the manager thought this would be effective. The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.doc Version 1.30 Page 13 Residents, staff and visitors said the meals were good. Records are kept of the meals served although these did not correspond with the menus. Records show the meals are varied and nutritious. Residents did not know what they were having for lunch until it was served. The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.doc Version 1.30 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) 18 Important information is not always recorded, which does not enable events to be properly tracked therefore protection of residents and staff could be compromised. Staff and the manager need to be more aware of adult protection procedures and guidance. EVIDENCE: The manager and staff had serious concerns about one service user and a referral for reassessment and professional support had been made to the relevant agencies. Staff said they were unable to meet the person’s needs, and other resident’s became distressed; serious incidents had occurred and had not been recorded. The manager and staff were aware of the adult protection unit but were unsure of their remit. They are waiting to attend training which is provided by the adult protection unit. The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.doc Version 1.30 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) 19, 20, 24 & 25 Residents are comfortable in the home, which is clean and tidy, and well maintained. EVIDENCE: The inspector visited most areas of the home, including resident’s bedrooms. It was clean and tidy, well maintained and there were no odours. Several residents said they liked their rooms and the lounges. One resident said they were lucky because they had a lovely view from their bedroom. The majority of radiators have guards fitted and this process is ongoing. Many bedrooms had new matching furniture, and residents have brought personal items with them, pictures and photographs were displayed in most of the bedrooms. Some lights and lamps were not working. The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.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 Staff are proud to work at the home and they understand what is good care. The home is adequately staffed. EVIDENCE: Relatives made very positive comments about the staff and said they were caring and patient, and had a good attitude, they also said there was a good atmosphere in the home. When asked what the home does well staff responded with ‘good care, look after the residents well and make them happy’. Staff spoke of promoting independence, and gave examples where residents have made good progress, they were able to describe how they meet different types of needs. Staff rotas were examined. Staff confirmed that although they can get very busy, there is time to complete tasks properly. The manager has the authority to bring in additional staff to work if necessary. The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.doc Version 1.30 Page 17 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) 32, 35 &38 The manager is popular, approachable, and promotes a resident focused service, which has improved the standard of care in the home. Good systems have been introduced to ensure health and safety checks are completed. The staff team do not receive enough opportunities to discuss issues as a team, which has resulted in some information not being passed on to all relevant staff. Recording systems are inconsistent, which can be misleading. The manager should be aware of financial arrangements to ensure resident’s finances are protected. EVIDENCE: Staff and relatives said the home has improved since the manager started working at the home. One relative said there has been real improvement and the manager has made a difference. Staff said that the home is well organised and the manager tries to give the residents what they want, they spoke of small personal touches that have been introduced by the manager such as The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.doc Version 1.30 Page 18 fresh drinks in resident’s bedrooms and more individual choices. Staff said sometimes information regarding residents and resident’s reviews is not passed on to all staff, and they have discussions but this tends to be on an informal basis with those on duty. Only one staff meeting has been held within the last twelve months. The manager had good up to date knowledge of individual residents and has everyday involvement with residents and staff. Accident records are held in individual files, with no system to enable the manager to monitor accidents within the home and take action if required. Daily records are completed several times a day. Dated information contained conflicting information about service users, for example some information stated no change but on the same issue other records showed considerable change. There have been no formal monitoring visits since January 2005, which could have highlighted some of the shortfalls in the recording systems. Staff do not receive regular formal supervision. The manager and deputy have agreed a supervision format, and six staff did receive supervision in January 2005, however, no further sessions have been held. A quality control manager used to visit the home, however, these visits have not been completed since January 2005. Financial records are available for monies that are held on behalf of any residents. The manager was unable to confirm who is responsible for the finances for two residents and was unsure what arrangements are in place. Records of regular maintenance and service checks are maintained, including fire tests, emergency lighting and window restrictors. The home’s maintenance worker services two hoists. The last inspection required the registered provider to confirm in writing that a competent person has serviced the hoists; the home has not yet confirmed this. The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.doc Version 1.30 Page 19 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 1 x 2 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 x 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 3 x x x 3 3 x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 1 x 2 x x 2 x x 2 The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.doc Version 1.30 Page 20 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 OP1 Regulation 6 Timescale for action The registered person must 31st July review the statement of purpose, 2005 and ensure staff are familiar with the contents of the document. Timescale of 28/02/05 not met). The registered provider must 31st July ensure service user guides are 2005 available in the home. (Timescale of 28/02/05 not met). The registered manager must 31st ensure service user plans set out August in detail how health, personal 2005 and social needs are to be met. The registered manager must 30th June ensure the medication practices 2005 comply with the relevant procedures. The registered provider must 30th June ensure that all staff are familiar 2005 with the adult protection procedures and relevant training should be provided. (timescale of 30.09.04 & 31.01.05 not met) The registered manager must 30th June ensure relevant information is 2005 recorded. The registered provider must 31st July make available in the home 2005 financial records for monies that are held on behalf of residents. Version 1.30 Page 21 Requirement 2. OP1 5 3. OP7 15 4. OP9 13 5. OP18 13 6. 7. OP18 OP35 17 17 The Raikes v225057 j52 j03 s1298 the raikes v225057 130505 stage 4.doc 8. OP38 23 9. *RQN 26 The registered provider must forward evidence to the commission that a competent person is servicing the hoists. The registered provider must make available to the Commission a copy of reports produced under Regulation 26. (timescale of 31.08.04 and 31.01.05 not met) 31st July 2005 31st July 2005 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. 5. 6. Refer to Standard OP3 OP1 OP15 OP32 OP36 OP38 Good Practice Recommendations The registered manager should ensure pre admission assessments contain adequate information about a residents needs. The registered manager should review group activities. The registered manager should update the menu and ensure residents are informed of meals to be served. The registered manager should introduce regular staff meetings. The registered manager should ensure staff receive formal supervision at least six times a year. The registered manager should introduce a system for auditing accidents. 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