Inspection on 08/06/06 for The Raikes

This inspection was carried out on 8th June 2006.

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 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

The Raikes 20/08/09

The Raikes 07/06/07

The Raikes 01/11/05

The Raikes 13/05/05

The Raikes 16/11/04

The Raikes 08/06/04

Similar services:

Snydale Care Home

Abbey The

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 West Yorkshire BD20 9JN Lead Inspector Ashley Fawthrop Key Unannounced Inspection 8th June 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 The Raikes DS0000001298.V299234.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. The Raikes DS0000001298.V299234.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Raikes Address Bradley Road Silsden Keighley West Yorkshire BD20 9JN 01535 653339 01535 653952 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) Crabtree Care Homes N/A Care Home 31 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (18), of places Physical disability over 65 years of age (10) The Raikes DS0000001298.V299234.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2005 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 currant rate of fees range between £330.00 and £380.00 additional charges are invoiced for hairdressing, chiropody, Wednesday club (in the village) and occasional clothes parties. The Raikes DS0000001298.V299234.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out the inspection in one day. The process of the inspection included talking to the manager and staff, reading records, documents and policies and procedures relating to the care of the service users, protection of service users and health and safety. Three service users were case tracked from admission to the date of the inspection to ensure the care and care plans reflected the changing needs of the individuals. Service users, their relatives where possible and staff were spoken with and their comments are reflected in the report. The prospective manager and staff were open and honest in their response to the inspection and pre inspection information was received well before the inspection date showing a willingness to work with the commission. There were many areas of good practice seen on the day of the inspection relating to care plans, training, activities and the principles of care relating to privacy, dignity and individuality. There were some inconsistencies identified as were areas of improvement and these are documented in the requirements and recommendations of this report. What the service does well: The home continues to provide good care. Residents and relatives said they were very happy with the care provided one relative said, “I think the staff are wonderful the care for my relative is wonderful”. Others said they were happy with the new manager and she was approachable. They were aware of the complaints procedure and how to complain. Service users were complementary about staff. They knew the names of the staff on duty and were given the opportunity to go out and organise their own days. The training opportunities for staff are excellent and exceeds the standard required. The Raikes DS0000001298.V299234.R01.S.doc Version 5.2 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. The Raikes DS0000001298.V299234.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 The Raikes DS0000001298.V299234.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 6. Quality is adequate in this area. This judgement has been made using available evidence, including a visit to the home. The home does provide information on the service so that prospective service users can decide if the home can meet their need. However, the statement of purpose is to be updated to reflect the service the home provides. The storage of contracts is inconsistent therefore it cannot be judged that all the service users are receiving an agreed service. The pre admission assessments and visits by prospective service users is also inconsistent, the assessments that are complete give good evidence of the assessed needs, however, there are gaps in others so their needs cannot be seen as being assessed in full. EVIDENCE: The statement of purpose is available to prospective service users and their representatives. The document is included in a pack that contains the philosophy of care and daily activities. There is also information on the environment and policies regarding personal possessions, finances and The Raikes DS0000001298.V299234.R01.S.doc Version 5.2 Page 9 complaints. The statement does not reflect accurately the care and a service provided by the home and is in the process of being updated. Contracts and terms and conditions for service users were available on some files, but not on others therefore proof that all the service users were receiving the agreed service was not evident. There were pre admission assessments on two out of the three service users case tracked and one was missing, however for the one that was missing the service user had been admitted some years ago and the assessment could have been mislaid over the years of those that were seen one was completed, however, the other did have information missing, this information related to the service users mood and emotional state and on this particular case the information was relevant as the service users orientation to time and place is a concern. I was informed that where possible the service users or their representatives do visit the home before admission, however, there is no evidence in the care plan therefore an opportunity to make an assessment has been missed. The Raikes does not provide intermediate care. The Raikes DS0000001298.V299234.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10 Quality in this area remains adequate. This judgement has been made using available evidence, including a visit to the home. The home does keep some good records on care planning, however, inconsistency continues to be evident. Service users and their representatives are involved in care planning and are happy with the level of care provided. EVIDENCE: Three service users were case tracked as part of the inspection and information on the whole was consistent in each plan and related to the needs of the individual service user. Assessments on daily living were available as were risk assessments relating to mobility, mental and physical needs. On many of the care plans good information was available on life histories and pen pictures giving staff a picture of an individuals past experiences and what makes them individual, however, inconsistency was again evident where in one case this important information was missing. The Raikes DS0000001298.V299234.R01.S.doc Version 5.2 Page 11 There was evidence that service users have access to other services such as GP’s dentists, opticians, chiropodists and other NHS services and these were recorded on the plan. There was documented evidence that service users and their representatives were involved in the planning of the care and were involved in specific approaches to care through risk assessments. Monthly reviews were consistent on all the plans seen and the information was good. The last inspection identified that improvements should be made to medication procedures. These have been implemented and the system is safe. I spoke with two visitors they said that they were happy with the level of care provided and were very happy with the approach of the prospective manager, they said that she was approachable and acted on any issues that were raised. On talking to service users they were happy with the care they received, friends and relatives were welcome at all times and they were very happy with the care provided by staff. The Raikes DS0000001298.V299234.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this area is good. This judgement has been made using available evidence, including a visit to the home. Interaction and social activities are seen as important and service users are given the opportunity to be involved. However, the activities should be made more meaningful by including socialisation as part of care planning and to be seen as an important part of life. There are good relationships between staff and service users. EVIDENCE: I observed the interaction between staff and service users and these were relaxed and respectful. During meal times staff were attentive to the needs of service users who needed assistance and were observant of people who were not eating. Service users were not rushed and the meal appeared relaxed. The meal provided on the day was the meal recorded on the menu. As well as protein, vegetables and fruit were included in the meal. There was banter between some service users and staff this was in good humour and not patronising. The Raikes DS0000001298.V299234.R01.S.doc Version 5.2 Page 13 On touring the building service users were seen enjoying the privacy of their own rooms and entertaining visitors. There is a statement on visiting in the statement of purpose and there are no restrictions. Service users were involved in activities and staff were seen to sit and talk to service users. The activities that are provided include bingo and entertainers. Representatives from different religious denominations visit regularly. There are a number of service users that go out with their relatives or to clubs in the area. At the time of the inspection socialisation was not part of the care plan. I recommended this be included as social and psychological health and needs are as important as physical needs and should be addressed equally. Service users that do go out are not risk assessed. I informed the prospective manager this must be done as part of the care plan to ensure that the level of risk is acceptable. The Raikes DS0000001298.V299234.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this area remains poor. This judgement has been made using available evidence, including a visit to the home. Service users representatives were able to raise concerns and complain if necessary. This is seen as important to the home as they have acted on issues in the past. Service users are safeguarded from abuse. EVIDENCE: On speaking to visitors I was informed that if they had complaints or concerns they would report these to the manager. Concerns have been raised in the past and these had been acted upon and the outcome was positive. The prospective manager said that there had been no complaints received since the last inspection. There is a complaints procedure available in the service users guide and continues to be on display in the home. Eight members of staff have attended the adult protection training facilitated by Bradford social services. There are policies and procedures relating to the protection of vulnerable adults and whistle blowing and are available to staff. The Raikes DS0000001298.V299234.R01.S.doc Version 5.2 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 the following standard(s): 19, 21, 23, 24 and 26. Quality in this area is good. This judgement has been made using available evidence, including a visit to the home. The home is well maintained, service users have the opportunity to express individuality and have ownership of their rooms. The home is clean and tidy and the laundry is appropriately staffed. EVIDENCE: On inspecting the building there was evidence that the home is maintained to a good standard and records are maintained. Staff are employed specifically to maintain the home. Most of the rooms have now been refurnished and service users have the opportunity to furnish their bedrooms with personal items giving them a feeling of ownership and an expression of individuality. The home was clean and tidy and the laundry was well organised both laundry and cleaning staff are employed additionally to the care staff. There are sufficient bathrooms and WC’s and there are plans to convert one into a shower room with wheelchair access. The Raikes DS0000001298.V299234.R01.S.doc Version 5.2 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 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): 27, 28, 29 and 30. Quality in this area is adequate. This judgement has been made using available evidence, including a visit to the home. Staff that have been inducted and trained to a good standard meet service users needs. However, records relating to the Criminal Records Bureau are poor and must be improved. EVIDENCE: The service users and relatives were complimentary about the staff a number of service users knew the names of the staff on duty. Individuals said they could get up in a morning and retire to bed when they wished and one visitor said “I think the staff are wonderful and the care of my relative is excellent”. Evidence to support this comes in the training undertaken by staff and recently has included a continuing NVQ training programme at levels 2 and 3. Other training includes nutrition and healthy living, dementia care and challenging behaviour, safe handling of medications, food hygiene and moving and handling. Some staff have also undertaken training in infection control and palliative care. The Induction training is in line with Skills for Care and is completed to a good standard. I spoke to two new members of staff both informed me that they had received an orientation day on the day they started work so they were aware of the fire The Raikes DS0000001298.V299234.R01.S.doc Version 5.2 Page 17 procedure and emergency exits as well as being introduced to staff and service users. They have both received training since commencing their employment, however, though both are senior staff neither administers medication as they have not received the appropriate training as yet this is good practice and reduces the risk of mistakes being made. I inspected the files of four staff, most of the information relating to application forms for employment, references, inductions and training and development was available, however, the record of criminal records checks were unacceptable. On all the files seen with exception of one the record of the criminal records check was a photocopy of the original information such as the name of the member of staff the check referred to was missing it was impossible to check against the file. The registered person must ensure that the record is available at the home with all the details of the individual available so that these can be checked against the application for employment. The Raikes DS0000001298.V299234.R01.S.doc Version 5.2 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 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): 31, 32, 33, 35, 36 and 38. Quality in this area is good. This judgement has been made using available evidence, including a visit to the home. The prospective manager has been employed using the homes recruitment procedures and no concerns were raised regarding her fitness to manage the home. Service users monies and finances are protected by the improved procedures. The service users, visitors and staffs health and safety is maintained by the policies and procedures and inspections to vital services by competent persons. The Quality Audit does not truly reflect the opinions of service users and relatives; however, the system is continuing to develop. EVIDENCE: The Raikes DS0000001298.V299234.R01.S.doc Version 5.2 Page 19 A new prospective manager has recently been employed and an application has been made to the Commission for registration through the fit person process, she is to commence NVQ level 4 with the Care Managers award. As part of the homes Quality Audit the home is asking service users and their representatives for comments in the form of a questionnaire and is responding to these on an individual basis. I recommended that where an individual response is not required and a number of people have made similar suggestions or comments the action that you have taken in response could be displayed in the home or could be attached to the statement of purpose so that existing and prospective service users can that the home acts on comments made about the home and is evidence that they are involved in the managing of the home. The information must also be used in the plan for the homes future development. The last inspection identified that improvements must be made to the record of service users monies for safekeeping. I was informed that the policy and recording has now been amended all receipts are now kept for individual purchases. The record also includes the details of purchase the amount paid out the balance and two signatures. Formal supervision has commenced and many of the staff have a record of supervision on file, however, within the last few months the practice has stopped and a lot of the good work will be lost. The prospective manager must continue to plan in supervision time for all the staff if she is to reach the target of six supervision sessions for each member of staff annually. There are health and safety policies and procedures in place. Staff undertake training in health and safety, infection control, basic food hygiene and moving and handling. The fire system is checked on a regular basis and staff undertake fire training. The last inspection identified that there was no evidence was available that a competent person had serviced the hoists. A certificate was available at this inspection. Inspections to the water systems and gas supply have been undertaken and an inspection of the homes main electrical wiring system has been arranged for August 2006. The Raikes DS0000001298.V299234.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X 3 3 X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 X 2 X 3 The Raikes DS0000001298.V299234.R01.S.doc Version 5.2 Page 21 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 OP1 Regulation 6 Requirement The registered person must review the statement of purpose, and ensure staff are familiar with the contents of the document. (Timescale of 28/02/05 & 31/07/05 & 31/12/05 not met). Where pre admission assessments are undertaken all the information relating to the individuals disabilities and needs must be included. All the information required to ensure the care plan is fully completed must be available without gaps Social needs must be included, as part of the care plan, where service users choose to go out a risk assessment must be undertaken to ensure the risk is acceptable. The registered person must not employ a person unless all the relevant information has been obtained. This refers to employment history and criminal record checks. (Timescale of 30/11/05 not met) Supervision of staff must be DS0000001298.V299234.R01.S.doc Timescale for action 31/07/06 2. OP7 14(1)(a) 30/09/06 3. OP7 15(1) 30/09/06 4. OP12 13(4)(b) 31/07/06 5. OP29 19 30/07/06 6. OP36 18(1) 31/07/06 Page 22 The Raikes Version 5.2 7. OP33 24 continues so that each member of staff has 6 supervision sessions in a 12-month period. The registered manager must introduce a system for reviewing the quality of care; this must include consultation with residents. (Timescale not met 28/02/06) 30/08/06 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 OP2 Good Practice Recommendations The registered person should issue statements of terms and conditions to residents when they move into the home. The Raikes DS0000001298.V299234.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 The Raikes DS0000001298.V299234.R01.S.doc Version 5.2 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!