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Care Home: Rathgar Residential Care Home

  • 349 Kettering Road Spinney Hill Northampton NN3 6QT
  • Tel: 01604499003
  • Fax: 01604499003

Rathgar Residential Care Home is situated in a residential area on the main road to Kettering near to the towns boundary. The home provides 9 single rooms and 7 shared rooms all with washbasin facilities. Some rooms have en-suite toilets and wash hand basins. On the ground floor residents have access to a small seating area in the hallway from the hall there is access to a large lounge and separate dining room. A further communal area is available in the conservatory. Residents have access to a range of bathroom facilities that are equipped with bath lifts. There is a small rear garden and courtyard that some of the ground floor bedrooms over look. The provider makes information available to residents and their representatives through regular meetings. The Commission for Social Care Inspection reports are available on request and people are informed about the reports along with the Statement of Purpose and Service Users Guide prior to admission.

  • Latitude: 52.262001037598
    Longitude: -0.86900001764297
  • Manager: Manager post vacant
  • Price p/w: £394
  • UK
  • Total Capacity: 23
  • Type: Care home only
  • Provider: Golden Care (UK) Limited
  • Ownership: Private
  • Care Home ID: 12752
Residents Needs:
Old age, not falling within any other category, Dementia

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for Rathgar Residential Care Home.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rathgar Residential Care Home 349 Kettering Road Spinney Hill Northampton NN3 6QT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Stephanie Vaughan     Date: 1 5 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Rathgar Residential Care Home 349 Kettering Road Spinney Hill Northampton NN3 6QT 01604499003 01604499003 avedd@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Golden Care (UK) Limited Type of registration: Number of places registered: care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: No one falling within the categories of OP and DE(E) may be admitted to Rathgar Residential Care Home where there are 23 persons within the categories of OP and/or DE(E) already accommodated. The maximum number of persons to be accommodated within Rathgar Residential Care Home is 23. Date of last inspection Brief description of the care home Rathgar Residential Care Home is situated in a residential area on the main road to Kettering near to the towns boundary. The home provides 9 single rooms and 7 shared rooms all with washbasin facilities. Some rooms have en-suite toilets and wash hand basins. On the ground floor residents have access to a small seating area in the hallway from the hall there is access to a large lounge and separate dining room. A further communal area is available in the conservatory. Residents have access to a Care Homes for Older People Page 4 of 31 Over 65 23 23 0 0 Brief description of the care home range of bathroom facilities that are equipped with bath lifts. There is a small rear garden and courtyard that some of the ground floor bedrooms over look. The provider makes information available to residents and their representatives through regular meetings. The Commission for Social Care Inspection reports are available on request and people are informed about the reports along with the Statement of Purpose and Service Users Guide prior to admission. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The previous Key Unannounced inpection was conducted on the 19th March 2007. The quality rating for this service is 2 star. This means the people who use this service experience good outcomes. The current fees range form 359 to 462 Pounds per week, a top up rate of 20 - 30 Pounds per week may be charged depending on the individual needs and circumstances. Additional charges are made at variable rates for hairdressing, podiatry, newspapers, toiletries and other personal items. Prior to this statutory inspection, a period of five hours was spent in preparation. This comprised reviewing the Annual Quality Assurance Assessment, a document sent to us Care Homes for Older People Page 6 of 31 by the provider, the previous inspection reports and associated requirements, the service history and other documentation. A total of 7 Comment cards were received from people who use the service and 4 from staff. These told us that people are generally satisfied with the service that is provided by Rathgar Residential Care Home. The Commission have received no concerns or complaints about this service. There have been six Safeguarding Adults allegations relating to incidents between individual residents; these have been subject to referral and independent investigation under the Local Authority Guidelines for the Safeguarding of Adults. In one of these there was no evidence to support the allegations and the outcome for the remainder is as yet unknown. The Commission have a focus on Equality and Diversity and issues relating to this are also included in the main body of the report. This site visit to the home was conducted over a period of seven and a half hours during which we made general observations and conducted a Short Observational Framework Inspection (SOFI) designed to gather information by observation for people who can not recall or express their experiences of living at the home. We also spoke to residents, relatives and staff. A limited tour of the premises was conducted which involved viewing the communal areas and a selection of the private accommodation. Case tracking is the method used during inspection where of a sample of three residents were selected and all aspects of their care and experiences are reviewed, including individual plans of care and associated documentation. The Acting Manager and the Responsible Individual were present throughout this inspection. What the care home does well: What has improved since the last inspection? Each resident has an individual plan of care and the standard of these has been improved since the last inspection. The staff make sure that the people who use the service have the right checks to make sure that they can be cared for properly and that they are safe. The management have involved the Falls Coordinator in reviewing the care of residents who are assessed as being at high risk of falls, the service are now monitoring all accidents and incidents on a monthly basis to make sure that they can reduce the risks of them reoccurring, staffing levels have also been increased. As a result of these combined actions there is now evidence that the number of falls in the home have been significantly reduced. The Individual plans of care show that the staff are now beginning to record information about the previous life styles of the people who use the service. This means that they can arrange appropriate activities and routines to support residents to maintain their preferred lifestyles. Care Homes for Older People Page 8 of 31 The service is now making appropriate referrals to all of the appropriate authorities when incidents occur between individual residents. Staff also now make sure that the right checks are in place to ensure that the staff take the right action to prevent further incidents. The management have made several improvements to the environment including the installation of radiator guards to reduce the risk of burns, bathroom and laundry facilities have been improved. Other improvements include the redecoration and refurbishment of some of the bedrooms and the dining room and improved fixtures and fittings to ensure privacy and wheel chair access. Staffing levels have been increased to make sure that there are enough staff on duty at the week ends and a week end cook has been appointed. Staff members told us that this had made a lot of difference to the amount of time that they are able to spend with the people who use the service. Recruitment practices have been significantly improved since the last inspection all staff now have the right checks in place before they start working in the home. Staff also have the right training at the right time so that they can look after the people who use the service safely and according to their need. One of the strengths of Rathgar Residential home is the fact that the Responsible Individual works along side the Acting Manager and has a hands on approach to management. 14 requirements and 14 recommendations were made as a result of the previous unannounced Key Inspection and one as a result of a random inspection conducted on the 12th & 13th May 2008. The management have demonstrated a strong commitment to complying with both requirements and recommendations and also a willingness to work with the Commission to achieve better outcomes for the people who use the service. The acting Manager has almost completed her Registered Managers Award and is due to commence further training and to seek registration with the Commission. The management of residents money has now been reviewed and is stored appropriately with the necessary records. What they could do better: Individual plans of care could be improved by involving residents or their representatives in the care planning process and review, so that the plans of care become more individualised and person centred. Medication systems need to be reviewed to make sure that residents receive their medication as prescribed at all times. The management need to make sure that they have the right information about when to notify the Commission about incidents that occur in the home that affect the well being of the people who live there. The management need to make sure that they fit window restrictors to all of the Care Homes for Older People Page 9 of 31 windows so that people can not fall out of them. The management need to make sure that they do random out of hours visits to the service so that they can support and supervise staff appropriately. The service specialises in the care of people with dementia at present the acting manager does not have any formal qualifications in Dementia and should consider obtaining some so to ensure current best parctice. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has robust admission procedures, which ensure that residents needs and expectations can be met. Evidence: The service has a Statement of Purpose and Service Users Guide; the management confirmed that there have been no changes to ether of these documents since the last inspection. The service has a comprehensive preadmission assessment, which is used to ensure that the service has adequate information before deciding whether they are able to meet the needs of a prospective resident. The Acting Manager conducts these assessments. People who use the service are provided with information about the home and are able to visit the home, meet other residents and the staff, they are also able to have a meal. If they are unable to visit the home the management encourage their representative to come and see the facilities on their behalf. There was evidence that people who use the service have individual contracts in place that specify the Care Homes for Older People Page 12 of 31 Evidence: terms and conditions. The service does not provide intermediate care Care Homes for Older People Page 13 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and staff are responsive to the needs of the individuals and take action to ensure good outcomes for residents. Evidence: People who use the service have an individual plan of care which is based on the preadmission assessment and provides instruction to staff about how the resident is to be cared for. Following a recommendation made at the last inspection the content of the individual plans of care have been improved and now provide more detail about residents needs and preferences, these are reviewed on a monthly basis. However as yet there is little evidence to show that either the residents or their representatives are involved in the care planning and review process to enable the plans of care to become more person centred. Care Homes for Older People Page 14 of 31 Evidence: Following Requirements made at the last inspection there is evidence that people who use the service now have comprehensive risk assessments in place to reduce and manage the risks with falls, falls from the bed and the associated use of bed rails. Since the last inspection there is also evidence that the service has sought guidance from the Falls Coordinator to reduce the number of falls in the home. Following a Requirement made at the last inspection people who use the service now have comprehensive assessments in place for the risks associated with pressure. There is also evidence that they have access to appropriate pressure relieving equipment. People who use the service also have appropriate assessments in place for the risks associated with nutrition and access to dieticians when needed. People who use the service have access to appropriate health care services such as General Practitioners, District Nursing and Continence Nursing Services, audiologists, dentists, opticians,chiropody services and hospital facilities. One relative commented the home acts swiftly to get medical support. Another commented I am more than pleased with all aspects of Rathgar. Another comment was The general level of care received is excellent and We are kept informed of any changes. People who use the service were well presented and appeared to be well cared for. Medication systems were reviewed; In general the service uses a monitored dose system supplied by a high street chemist, in occasional circumstances the medication is supplied in traditional containers. Medication Administration Records were viewed and seen to be in general good order. However there was evidence that a recent medication error had been made relating to medication that was not included in the monitored dose system. This error was discovered soon after the event and appropriate action was taken to seek advice form the General Practitioner and the hospital. There was evidence that this advice had been acted on and an investigation into the circumstances is ongoing, the Commission have asked the service to tell us what action is going to be taken to prevent this sort of error from occurring in the future. Another medication administration record indicated that a resident may not have been given his medication on one recent occasion, the audit trail enabled us to track back and identify that the amount prescribed was sufficient for a 28 day supply which meant that there should have been another four days supply remaining. However there were no tablets remaining in the box meaning that we could not identify if the Care Homes for Older People Page 15 of 31 Evidence: medication had been given but not signed by staff to show that it had been given or had just not been given. Immediate action was taken to obtain further supplies to ensure that the next dose could be given as prescribed and the management have contacted the pharmacist to request that the medication is supplied in a format that does not require the staff to have to break the tablets in half - which presents them with difficulties in storing the remaining half of the tablet securely, or to have half of the tablet disintegrate when it is broken in half. We have asked the service to tell us what action they are going to be take to prevent this sort of problem from occurring in the future and to ensure that the Medication Administration Records are maintained in good order at all times. Following a recommendation made at the last inspection the service has obtained an appropriate medication storage cabinet that complies with the requirements of the Royal British Pharmaceutical Society Guidelines. A period of 90 minutes was spent in observing care practices in the home using the SOFI (Short observational framework Inspection) tool. This showed that the staff related well to the people who use the service, using their preferred form of address and that they were sensitive to their needs and wishes. Good Movement and Handling practices were observed and it was also observed that residents are able to receive medical attention in private. Care Homes for Older People Page 16 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals are both managed well, are creative and provide daily variation and interest for people living in the home. Evidence: Three residents were case tracked and the individual plans of care showed that the staff are beginning to record information about the residents previous lifestyle so that they can involve them in conversations and activities that support their previous experiences and interests. There was also evidence that they are supported to make decisions in their daily lives as to whether they participate in activities and maintain their faith. There is a varied activities program with up to three activities a day; these are appropriate to the age and gender of the people who use the service. In the mean time appropriate music and television programs are available. Staff also spend time chatting with residents about the things that interest them. The SOFI inspection identified that routines including meal times are flexible people can choose to spend time in their bedrooms if they wish. Two residents were reading Care Homes for Older People Page 17 of 31 Evidence: the newspaper and swapped them when then had read their own, others chose to sit near the front window and watch what was going on outside. People who use the service are supported to maintain their faith if they chose to do so. All residents are white British with English as their first language as such the activities, meals and arrangements for them to support their faith are appropriate. Through discussion with management it was established that the service was inclusive to other cultures and that arrangements could be made for the needs to be met for individuals from other cultures or sexual orientation. Visiting times are also flexible and visitors were seen to come and go. One relative commented that they were always made welcome and said that the staff are very nice, they always keep in touch and tell us about things when they change. The home is always comfortable clean and fresh and people are well looked after. The service has a varied seasonal menu in place, this shows that there are three meals a day with at least one hot meal, snacks are also available. Vegetarian alternatives are also listed and people can opt for a different alternative altogether if they do not like the options that are on the menu. The preferences of people who have limited abilities to communicate are known to staff and are either incorporated into the menus or alternatives are provided. People who use the service told us that they liked the food and that the staff knew the things that they liked to eat. Lunchtime service was viewed - this was served in the dining room or the sitting room, meals were relaxed and unhurried. Residents requiring assistance were sensitively supported. The service also supports residents who require special diets for diabetes or soft diets. Comments from residents and relatives included the food is excellent and there are usually some activities that I can participate in. A relative commented The staff are welcoming and patient. Care Homes for Older People Page 18 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A comprehensive procedure for handling complaints and ensuring Safeguarding Adults is in place ensuring that the people who use the service are protected. Evidence: We have received no concerns or complaints about this service and the complaints file within the home showed that there had been no complaints received directly by the service since the last inspection. The complaints policy is included in the Statement of Purpose and Service Users Guide. Residents and relatives spoken to during the inspecting said that they knew how to complain should they need to do so. Following a Requirement made at the last inspection the service now complies with the Local Authority Guidelines on the Safeguarding of Adults and submits appropriate alerts regarding events that have Safeguarding Adults implications. Six alerts have been sent since May 2008 one allegation was that a member of staff had shouted at a resident, this has been investigated and no evidence was found to support the allegation. All others involve allegations of concerns or incidents between residents, four of which relate to one person. These allegations are still under independent investigation by the Local Authority. Evidence suggests that the service is taking action to ensure the Safeguarding Adults, by making the appropriate referrals to the Local Care Homes for Older People Page 19 of 31 Evidence: Authority and also involving other health professionals, including mental health professionals such as Consultants and Community Mental Health Nurses for advice about the management of residents with particular needs. The management are mindful of the need to ensure that they conduct appropriate risk assessments and to ensure that they are able to continue meet the needs of individuals. Following a Requirement made at the last inspection risk assessments are now in place to manage the needs of residents who exhibit challenging behavior. More recently Regulation 37 notifications are being sent to the Commission about events that affect the well being of residents including Safeguarding Adults alerts. Care Homes for Older People Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit form a safe and comfortable environment that meets their needs and expectations. Evidence: Rathgar Residential Care home is a period residential property that has been extended to provide care for 23 people. Following Requirements made at the last inspection the service has installed radiator guards to protect residents from the risks associated with high radiator surface temperatures. Bathroom facilities have also been reviewed and that there was evidence that the toilet seat in one of the en suite facilities had now been replaced. Laundry procedures have also been reviewed to ensure that the bed linen is laundered to ensure compliance with infection control guidelines. A touch pad lock has also been fitted to the laundry door to ensure the safe storage of substances hazardous to health. Other improvements that have been made since the last inspection include the decoration and refurbishment of the some of the bedrooms, including new carpets and furniture, alternative arrangements have been made for the storage of equipment such as wheel chairs, the dining room has been refurbished, improved screening has been Care Homes for Older People Page 21 of 31 Evidence: provided in shared rooms and a new ramp to enable wheel chair access to the garden. The home is accessible to wheel chair users, there is a passenger lift and the corridors are sufficiently wide. A limited tour of the premises was conducted which including a review of the bedrooms of the individuals selected for case tracking all of the rooms were clean and tidy. Rooms showed that people who use the service are able to bring in small items of furniture, electrical equipment such as televisions and personal memorabilia such as photographs. One of the rooms had no window restrictor fitted and there was approximately a six foot drop, this was bought to the attention of the Responsible Individual who has agreed to ensure that window restrictors are fitted to all windows within the immediate future. The service was clean and hygienic throughout; staff were able to confirm that all equipment was in good working order. There are adequate supplies of hot water and this is dispensed a safe temperatures. Care Homes for Older People Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels, recruitment and training ensure the people who use the service are in safe hands at all times. Evidence: The service has a duty rota that shows the staff who are on duty throughout the week. Following a Requirement made at the last inspection staffing levels have been reviewed. There are three carers on duty during the weekday daytime shifts in addition to the Resoinsible Individual and the Acting Manager. At the weekends there are four carers and an additional week end cook. Staff spoken to confirmed that increased staffing levels had enabled them to spend more time with the people who use the service. There is also evidence that the incidents of falls have been reduced as a result of the increased staffing levels and risk assessments. Two waking staff are on duty at night, supervision of the night staff was discussed and the Responsible Individual has agreed to arrange for spot checks to be conducted to enable the management to provide more support to the night staff and to apply quality assurance principles. Care Homes for Older People Page 23 of 31 Evidence: A Requirement made at the last Key inspection regarding recruitment practices. Following this two further visits were made to the home, a visit was made on the 12th May, which did not provide sufficient evidence to support compliance with the Requirement. A further requirement was made regarding the information that needs to be held on file until it had been seen by an inspector. A Random Inspection was conducted on the 13th May 2008 and on this occasion compliance was demonstrated. Staff files now evidence that appropriate Criminal Records Bureau Clearances are obtained for the staff who work in the home. There was also evidence that povafirst clearances are requested when necessary to enable staff to commence employment sooner. In these circumstances staff are supervised at all times until the full Criminal Records Bureau Clearance is obtained. Staff files evidenced that two references were obtained before people start working in the home and also evidence of previous experience and qualifications. Staff spoken to were also able to confirm that recruitment practices are robust and also confirmed access to training including a comprehensive induction. Each staff member has an individual training record which identifies what training that they have received and when it is due to be renewed. Records indicated that all staff have up to date training in mandatory subjects such a fire, Health and Safety, Movement and Handling, Infection Control and Basic Food Hygiene. Staff benefit from both internal training and external training for Fire Safety, Infection Control and the Safeguarding of Adults. Other recent training has been provided specific to the needs of the people who use the service, including diabetes, stoma care, the management of challenging behaviour and Dementia Awareness. Named individuals have training in First Aid and the service ensures that there is a qualified First Aider on duty at all times. Care Homes for Older People Page 24 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Outcomes for the people who use the service have been improved by the service being run in an organised and proactive manner that promotes their health and safety. Evidence: One of the strengths of Rathgar Residential home is the fact that the Responsible Individual works along side the Acting Manager and has a hands on approach to management. 14 requirements and 14 recommendations were made as a result of the previous unannounced Key Inspection and one as a result of a random inspection conducted on the 12th & 13th May 2008. The management have demonstrated a strong commitment to complying with both requirements and recommendations and also a willingness to work with the Commission to achieve better outcomes for the people who use the service. The Acting Manager has completed the Registered Managers Award and is about to commence her National Vocational Qualification in Care level 4. She has not yet Care Homes for Older People Page 25 of 31 Evidence: submitted her application to the Commission to seek registration, however it is anticipated that this will be submitted in the near future. The service specialises in the provision of residential care to people with Dementia , neither the Responsible Individual or the Acting Manager have a formal qualification in this subject and this should be considered to enable the service to develop and enhance the level of care that the management seek to provide. Quality assurance systems are in place, there are regular satisfaction surveys conducted and the results of these are displayed in the hall way and show a good level of satisfaction. The service also holds residents and relatives meetings so that they can express their opinions and various issues can be discussed and people who use the service can be informed about service developments. Other quality assurance practices include monthly medication audits, audits of care plans, environmental audits, consultations with residents about activities and menus. Following a Requirement made at the last inspection the management of residents money has been reviewed, accurate records are now being retained including receipts and balances, money is stored within individual containers within a secure facility. Staff supervision is ongoing to monitor the performance of individuals and also to enable the development of the staff team. Following a Requirement made at the last inspection the staff have received training in record keeping and the storage arrangements have been reviewed. Records were seen to be in good order and to be stored appropriately. Following a Requirement made at the last inspection the management have undertaken a review of the accident records to identify trends and risks to individuals, appropriate risk assessments are also in place, people at risk have been referred to the falls coordinator and staffing levels have been increased to enable residents to receive more support and also to be better supervised. Accident records are now being audited each month and there appears to have been a significant decrease in the number of incidents. Fire records were reviewed and seen to be in good order. The Annual Quality Assurance Assessment indicated that there had been incidents in the home that had affected the well being of residents about which the Commission had not been informed. Some notifications have now been sent, however this was discussed with the Responsible Individual during the inspection who has been advised about when it is appropriate to submit notifications. However the Responsible Individual should review the guidance issued by the Commission for Social Care Inspection that is available on Care Homes for Older People Page 26 of 31 Evidence: the Professional Website. Other areas for improvement include the fitting of window restrictors to ensure that no one can fall out or that intruders can gain access. Medication systems need to be reviewed to ensure the Safe Administration of Medication, including medication that is not stored within the Monitored Dose System. The implementation of random unannounced night checks by the management should also be introduced. Care Homes for Older People Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 9 13 Medication systems must be reviewed to ensure that all residents receive their medication as prescribed. Immediate Requirement By 18:00hrs 15/09/08 To ensure the safe administration of medication. 25/09/2008 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 13 Appropriate window resirictors must be fitted. To ensure the health and safety of residents. 26/09/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 4 7 7 31 38 Residents or their Representative should be involved in the development and review of their individual plans of care. Staff should receive training in the development of person centered care planning and there implementation A Representative of the management team should have accredited training in the care of people with dementia The management should implement random visits to the service out of normal working hours to ensure that staff are Page 29 of 31 Care Homes for Older People supported and supervised appropriately 5 38 The management team should review the guidance issued by the Commission regarding regulation 37 notifications and the occasions when these should be sent. Care Homes for Older People Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 31 of 31 - 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!

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