Care Home: Ravenscroft

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What the care home does well People felt that the home provided individualised care with good attention to detail, and input from all the relevant sources. Their health needs were also met and the onsite multidisciplinary team provided excellent support complementing the excellent care offered by the staff providing personal care. People at the home liked the staff and felt safe there. They also enjoyed the activities and meals at the home. Staff at the home are recruited to thorough procedures, with relevant checks, so that people in their care are protected. They have a good induction programme, and are offered a wide range of training and development opportunities. A high proportion of care staff, 19 out of 22, have at least NVQ level 2 in care, showing a commitment to development by the employer. The home is managed well, has good quality assurance systems and keeps records well. What has improved since the last inspection? The service provided has moved from different premises and cannot easily be compared to the previous service providing long term care for older people. The current service says that it has improved the food provided by listening to what people said and involving them in developing new menus. They have also improved the grounds so that people could sit outside in a more pleasant environment. What the care home could do better: The information provided to people before admission was unavailable due to a revision and reprint. This needs to be done as soon as possible so that people can have knowledge about the service prior to admission. This could also be provided in a number of different formats to assist people with different abilities. The service takes people who are assessed by people who do not work within the service, and sometimes a problem arises because of this. The Registered Provider should ensure that signed copies of their monthly monitoring visits are available for inspection. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ravenscroft Smelterwood Drive Stradbroke Sheffield S13 8RJ     The quality rating for this care home is:   three star excellent 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 Kenning     Date: 1 0 0 2 2 0 0 9 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. that people have said are important to them: They reflect the things 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 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Ravenscroft Smelterwood Drive Stradbroke Sheffield S13 8RJ 01142053888 01142037812 marina.glaves@sheffield.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Sheffield City Council Name of registered manager (if applicable) Stephen John Cullen Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Minimum staffing levels providing direct care to service users must be maintained as described in the supplement to the Handbook of Guidance on Registration, Inspection and Management of Residential Care Homes in Yorkshire and Humberside dated 13.9.91. The 35 OP beds can be used as SI/E Sensory Impairment for people over 65 years. Where additional services are provided, eg day care, outreach, escort duty, staffing for this must be over and above that required by Condition 2 by 010403 by 01/04/03. Date of last inspection Brief description of the care home Ravenscroft is an older style purpose built home in the Stradbrook area of Sheffield The home provides mainly short term and intermediate care for up to 35 older people over the age of 65. The service has a multi-disciplinary team of staff including social care staff, nurses, occupational therapists, physiotherapists, and visiting doctors. It is a two-story building accessible by stairs or lift. The home also has a day care provision Care Homes for Older People Page 4 of 24 care home 35 Over 65 35 0 Brief description of the care home four days per week. The home has an enclosed patio area. Car parking is provided. Copies of the last Commission For Social care inspection report were kept in the entrance for service users and their families to read. The weekly fees are available by contacting the manager, though not all services are charged for. The home charges extra for chiropody, toiletries, clothing, and hairdressing. Care Homes for Older People Page 5 of 24 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: three star excellent 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: This was an unannounced key inspection carried out by Stephanie Kenning, regulation Inspector. The site visit took place between the hours of 9:30 and 16:30. The Registered Manager Stephen Cullen was present throughout the visit, and received feedback at the end of the day. Prior to the visit the manager had submitted an Annual Quality Assessment (AQAA), which detailed what the home was doing well, and any plans for improving the service in the next twelve months. Information from the AQAA is included in the main body of the report. CSCI received 21 completed surveys from people using the service, staff and other Care Homes for Older People Page 6 of 24 professionals involved with the service. They made comments about the care and support provided, and some of these have been included in the report. On the day of the site visit opportunity was taken to make a tour of the premises, inspect a sample of care records, check records relating to the running of the home, and check some of the policies and procedures. Time was spent observing and interacting with people. Many people staying at the home, working at the home and visiting the home were seen and they contributed to the findings. The Inspector checked all the key standards and some additional standards. The inspector wishes to thank the people at the home for their time, friendliness and co-operation throughout the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 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 9 of 24 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service do not have access to up to date information about the home, and are not assessed by the people who provide the service. This means that some people may not be placed appropriately. Evidence: We wanted to understand peoples experiences when they decide whether to choose this care home, and what it is like for people if they did decide to stay there. This home provides short term care including intermediate care and flexible care, designed to support people with their choice about their future. We spoke to people staying at the service, to some relatives, to staff and to the other health professionals involved with the service. We also received completed surveys from all these groups of people, helping to give their experiences of the service. We looked at the information the service gives to people and how they assess whether they can meet peoples needs. Care Homes for Older People Page 10 of 24 Evidence: People felt confident that they were getting the help that they needed from the service. Before staying there they had little information about it, and were unsure about what would happen in the long term. This was clarified by the manager who explained that the information about the service was being rewritten and printed, and not yet available to people using the service. He was able to show us the content of the new Statement of Purpose and Service User Guide, which did clarify the role and aims of the service. These were only planned to be in typed format with no plans for other formats such as video, pictorial, or audiotape to assist people who may find written information difficult. Prior to their admission to the service people were assessed by their social worker or by the hospital social worker. The staff at the home then made decisions about whether they could meet their needs based on the paperwork. Sometimes people had been admitted to the service who were not appropriate, or suitable, and the service struggled to meet their needs or expectations. An example of this was someone who required special equipment that the staff were unfamiliar with, and had to find someone to train them after the admission. The manager felt that by being clearer about the service aims people would not be referred incorrectly, and was keen to promote these once available from the printers. Whilst people are assessed for the service it would be helpful for people to be assessed by those with the responsibility for meeting their needs. Care Homes for Older People Page 11 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have their health and personal care needs met and receive medication safely. Evidence: We wanted to understand how people had their health and personal care needs met. We spoke to people in the home, observed practices in communal areas such as mealtimes, and looked at records and medication systems. People staying at the home were well presented and appeared calm and well. Personal care tasks were carried out in the privacy of their rooms or in the bathrooms. Staff treated people with dignity and respect, and followed the principle of doing with rather than for people. Some people stayed in bed later and some people spent a lot of time in their rooms, whilst others sat in the communal areas. Staff had goals and detailed action plans to follow from the individual person centred plans devised by staff following admission. They included information from nurses and Care Homes for Older People Page 12 of 24 Evidence: therapists involved in the care of the individual, and the daily intervention records were detailed and clear. People felt well cared for and had a health review following admission including blood tests and any other problems being sorted out. They liked the staff, felt confident in their abilities and found them very helpful. One relative stated that she asked the hospital to move her mother from the ward to the home as she knew that she would get good care. Good relationships with the nurses, GPs, occupational health and physiotherapists were noted and they felt that they worked well together. It was pleasing to see the good effects of such teamwork as people were supported to better health and then moved on to home or a place of their choice. People living at the home received medication via safe procedures. The storage and administration of medicines was managed well, with clear records and staff trained appropriately. Not many people were managing their own medicines which was surprising for a short term service where many people return to their homes. Care Homes for Older People Page 13 of 24 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. People staying at the home are able to choose appropriate activities and they enjoy the meals. Evidence: We wanted to understand peoples daily experiences and opportunities for leisure. We observed the routines and the activities taking place and spoke to people staying at the home. We looked at the record of meals, routines and activities. People staying at the home seemed to enjoy being there, and especially being with others, though some people preferred to be on their own. The organised activities were enjoyed and people told us about quizzes, games, dominoes, crafts, armchair exercises, outings and social evenings. The service has access to a minibus that they can use for outings. Visitors were welcomed and joined in with events if they wanted to. Meetings were held with people staying at the home, and any issues fed back to management, who tried to resolve them. The monthly newsletter given to people at the home mentions changes introduced as the result of feedback. There was a lot of praise for the meals, such as: they are smashing, I really enjoy Care Homes for Older People Page 14 of 24 Evidence: them, I give them 10 out of 10 for the meals, they are well cooked and fresh. On the day of the visit people were eating a lunch of fried fish, vegetables and potatoes, with soup for those wanting a lighter option, and followed by lemon sponge or rice pudding. As a result of the surveys people completed after their stay at the home, a food for thought initiative was introduced and people were involved in developing the new range of menus. Care Homes for Older People Page 15 of 24 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. People using this service are protected by the policies and procedures in place. Evidence: We wanted to understand how people were protected from abuse or neglect and how the service responds to complaints. We looked at records, policies and procedures and spoke to people staying and working at the home. People staying at the home felt safe and looked after. They knew who to talk to about any problems and felt listened to. Staff said that they had adult protection training and knew about safeguarding procedures and how to recognise potential abuse. A compliments file gave lots of evidence of previously satisfied guests. The home had dealt with 2 complaints in the past year, both investigated thoroughly, and one was substantiated. Action was taken immediately to rectify this by purchasing some equipment. There had not been any safeguarding referrals. Care Homes for Older People Page 16 of 24 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 stay in a home that is safe, comfortable and clean. Evidence: We wanted to understand what it was like to stay in the premises and whether they were appropriate for the lifestyles of the individuals staying there. We were shown around the premises including some of the rooms people were staying in. We spoke to people about the rooms and facilities. We observed people as they moved around the home in the communal areas. We looked at records of routine checks and maintenance, and observed the cleanliness of the home. Records showed that routine checks and maintenance were carried out to ensure that equipment was working well and safely. The building was clean, tidy, warm and maintained, and had been redecorated with new furnishings in some areas. People found the home and their rooms comfortable though they felt their rooms were small, and did not have any en-suite facilities such as a toilet. Space was also limited for therapists to work with individuals in their rooms, and may need to be considered in regard to future plans for the building. Care Homes for Older People Page 17 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by staff who are recruited to thorough procedures and trained well, to protect and develop individuals. Evidence: We wanted to understand how staff were recruited and trained to ensure that they could carry out their jobs well. We talked to people staying in the home, visitors and staff, including the manager. We Checked the recruitment files and the training records to see if procedures had been followed. We looked at the information in the surveys people had returned to us, and noted the comments they had made. People staying at the home and their visitors were very positive about the staff and the way they were treated by the staff. They felt that there were usually people available when they needed help, though staff found certain times very busy, for example when people were being admitted and discharged. The recruitment files demonstrated that all the necessary checks and procedures had been followed before someone is recruited in order to safeguard the people at the home. This included existing staff having their CRB check renewed every 3 years. The training records showed that people working at the home had a thorough induction, and a range of other training relevant to their roles. Records showed that 19 out of 22 Care Homes for Older People Page 18 of 24 Evidence: care staff held at least NVQ level 2 in care showing that the service values the development of the staff. The staff are also Care Ambassadors and are involved in local secondary schools raising their profile and professionalism within the community. Staff did feel well supported in their roles and received regular supervision, and attended regular meetings in order to keep up to date. They enjoyed working within a multi-disciplinary team and felt that they had learned a lot from each other. Care Homes for Older People Page 19 of 24 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. The service is well managed and people are protected by the systems in place. Evidence: We wanted to understand how the home was managed and ensuring the quality of service for the people staying there. We talked to people in the home, visitors,staff and the manager. We looked at records and surveys that we received from people. The Registered Manager is Stephen Cullen, who has many years experience working with older people and as a manager. He was well liked and respected by people at the home, and was observed to listen to the concerns of individuals. He is supported by a locality manager who visits the home regularly to ensure the home is being run well. Evidence of some of the provider visits was not available on the day of the visit. A survey is sent to people who have used the service, in order to find out what is working well, or to put things right if not. Other methods of gaining information were Care Homes for Older People Page 20 of 24 Evidence: being looked at to provide views about the service. As a result of the surveys previously, the service has involved people staying there in developing the new range of menus. They have also developed the grounds surrounding the home to provide a more pleasant environment for people to enjoy. The service, as part of the larger organisation, has been re-accredited with the Charter Mark, which assesses quality and value for money. Safe working practices are followed, and they follow a comprehensive range of policies and procedures that help to protect people using the service. Staff are well supervised, and assisted to develop their roles. Records are kept well including accident reports, and those relating to any monies kept in the home. There are plans to further develop the service and the quality assurance systems, including the introduction of Expert Elders to aid communication with people who use the service. Care Homes for Older People Page 21 of 24 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 22 of 24 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 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 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 1 3 Provide people with up to date information about the service and in different formats. Where possible people should be assessed by the staff providing the service to ensure that their needs can be met. Consider if there are ways for more people to be able to self medicate. Regulation 26 visits by the provider should be available and signed to show their authenticity by the Registered Provider. 3 4 9 31 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2009) 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 24 of 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!