Care Home: Richmond House

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What the care home does well The home is well managed and run in the best interests of the people who use the service. One person said as far as they were concerned ‘…there is nothing that could be improved upon. Everything is of the best.’Richmond HouseDS0000033217.V375429.R01.S.docVersion 5.2The people who use the services at the home said they are happy there and the home has a welcoming atmosphere. We were told that the staff do what people want in the way people prefer. One person said the staff ‘…always do the best they can.’ One person said ‘Richmond House is a shining example of how such homes should be run.’ Another person said the staff ‘Care very well for each person staying there. Treat them as individuals and care for their needs as appropriate to each person.’ People said they like the meals and the cooks make every effort to give people the foods they will enjoy. The home’s staff provide a wide range of activities and people take part or not as they wish. The staff understand the needs and preferences of all the people at the home. People’s health is looked after and the staff have the skills and experience they need to do this. Everyone said that staff listen to them, and act on what they say. One healthcare professional said, having visited the home over many years, she has ‘…only ever witnessed kindness and respect from staff to clients.’ There is good and friendly interaction between the people at the home and the staff. There seemed to be enough staff on duty to make sure they have time to spend with people in conversation as well as supporting people to take part in activities. Visitors said they are always welcomed. The home`s recruitment procedures are thorough, making sure that staff are safe to work with the people who live at the home All the staff said they enjoy working at Richmond House and felt they were well supported by their manager. They all said the training is good and helps them to do their job well. One member of staff said ‘I am proud to be a member of the staff team’ and another said ‘I have gained a lot of qualifications and have had a lot of support from my managers’ which has enabled them to progress. Eighty per cent of the care staff have achieved a National Vocational Qualification (NVQ) in care at level 2 or 3. The complaints and adult protection systems work well and people said they know and understand what to do if they have a concern. The home is clean and well maintained and everyone we spoke to said the home is kept fresh and clean.Richmond HouseDS0000033217.V375429.R01.S.docVersion 5.2Page 7 What has improved since the last inspection? We saw evidence that the plans are reviewed regularly. The plans include a ‘checklist’ for all the person’s care needs, which is completed when they first arrive at the home for a respite stay. This shows whether anything has changed since the person’s last visit. A conservatory has been built which gives extra living space on the ground floor. The bedrooms have all recently been fitted with a flat screen television. Since the last inspection the home now has the support of an administrator for a few hours each week. This has helped to free the two part-time managers and other senior staff from some of the reception and other administration duties. The home has a range of quality assurance systems in place, to help determine the quality of service the home offers. These include surveys for the people who stay at the home, their relatives and other people with an interest in the home. Staff have regular fire safety training, to make sure they can work well should an emergency occur. There are effective infection control measures in place throughout the home. What the care home could do better: The medication administration has improved, but there were still some inaccuracies which the management are dealing with. Although an administrator now works at the home for a few hours a week the overall management of the service could be improved with additional administrative hours, freeing more time for the senior staff to run the home. Key inspection report CARE HOMES FOR OLDER PEOPLE Richmond House Richmond Road Farsley Leeds LS28 5ST Lead Inspector Liz Cuddington Key Unannounced Inspection 19th May 2009 11:30 DS0000033217.V375429.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Richmond House Address Richmond Road Farsley Leeds LS28 5ST 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) 0113 2555010 0113 2558435 susan.avery@leeds.gov.uk Leeds City Council Department of Social Services Mrs Susan Avery Mimi Anderson Lawrence Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is: 20 22/05/07 2. Date of last inspection Brief Description of the Service: Richmond House is an older person’s home, owned and managed by Leeds Social Services. It is located in Farsley, which is near Pudsey and approximately 3 miles from the centre of Leeds. The home is close to a good range of local amenities and transport links. There are a total of twenty places available. Permanent accommodation is provided for one person; the remaining places are for people receiving a respite or intermediate care service. All of the bedrooms are single rooms, with en-suite facilities provided in the intermediate care rooms. There is very good access into the premises for people with disabilities and a shaft lift links the ground and first floor. There is outdoor seating provided and car parking is available. Copies of previous inspection reports are available in the home. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two stars – good service. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The current fees range from £102.90 per week for respite care to £497.30 per week for a permanent place. Additional charges are made for hairdressing, private chiropody and any other personal expenses. The purpose of this inspection was to assess the quality of the care and support received by the people who live or go to stay at Richmond House. The visit to the home was carried out over one day by one inspector. The last key inspection was in May 2007. The methods used to gather information included conversations with the people staying at the home, their relatives, the staff and healthcare professionals as well as looking at care plans and examining other records. We received the home’s self-assessment questionnaire (AQAA), which gave us a lot of useful information about the home. We also received surveys from people who live or go to stay at Richmond House, the staff and healthcare professionals. We would like to thank the people who were staying at the home, their relatives and the staff, for their welcome and hospitality and for taking the time to talk and share their views during the visit. What the service does well: The home is well managed and run in the best interests of the people who use the service. One person said as far as they were concerned ‘…there is nothing that could be improved upon. Everything is of the best.’ Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 6 The people who use the services at the home said they are happy there and the home has a welcoming atmosphere. We were told that the staff do what people want in the way people prefer. One person said the staff ‘…always do the best they can.’ One person said ‘Richmond House is a shining example of how such homes should be run.’ Another person said the staff ‘Care very well for each person staying there. Treat them as individuals and care for their needs as appropriate to each person.’ People said they like the meals and the cooks make every effort to give people the foods they will enjoy. The home’s staff provide a wide range of activities and people take part or not as they wish. The staff understand the needs and preferences of all the people at the home. People’s health is looked after and the staff have the skills and experience they need to do this. Everyone said that staff listen to them, and act on what they say. One healthcare professional said, having visited the home over many years, she has ‘…only ever witnessed kindness and respect from staff to clients.’ There is good and friendly interaction between the people at the home and the staff. There seemed to be enough staff on duty to make sure they have time to spend with people in conversation as well as supporting people to take part in activities. Visitors said they are always welcomed. The homes recruitment procedures are thorough, making sure that staff are safe to work with the people who live at the home All the staff said they enjoy working at Richmond House and felt they were well supported by their manager. They all said the training is good and helps them to do their job well. One member of staff said ‘I am proud to be a member of the staff team’ and another said ‘I have gained a lot of qualifications and have had a lot of support from my managers’ which has enabled them to progress. Eighty per cent of the care staff have achieved a National Vocational Qualification (NVQ) in care at level 2 or 3. The complaints and adult protection systems work well and people said they know and understand what to do if they have a concern. The home is clean and well maintained and everyone we spoke to said the home is kept fresh and clean. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 7 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 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. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 8 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 Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 9 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Wherever possible people are assessed before they are admitted to the home, to make sure their needs can be met. EVIDENCE: People said that, wherever possible, they were given enough information about the home before deciding to go to stay there. Where possible the staff encourage people and their families to visit the home and talk to the people who already spend time at the home, their relatives and the staff. The home invites them to come and spend time there, share a meal and maybe take part in the days activities. This means that the home can get Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 10 to know the persons needs and the individual has the information he or she needs to make a decision. Before going to stay at Richmond House, peoples needs are assessed to make sure that the home is able to meet their needs. This assessment, as well as Social Services and Health Authority needs assessments when available, forms the basis for the individual plan of care and support. Sometimes people are admitted following an emergency. When this happens the staff gather as much information as they can as quickly as possible, so that they can start to develop the care plan. Each time people return to Richmond House, their needs are re-assessed to find out if anything has changed, and if so the plan is adjusted to reflect the changes. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 11 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and healthcare needs are met. People are generally protected by the medication administration systems. Staff treat people with respect, care and consideration at all times. EVIDENCE: From observation and discussions with staff and people living at the home, it was clear that the staff are aware of each person’s needs and preferences. The staff make sure they provide the help people need in the way they prefer. One person said that ‘All the staff are very kind, courteous and caring.’ Another person said the home ‘Looks after me well.’ One healthcare Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 12 professional said the care people receive is responsive, truly personalised and focussed on individual care. Four care and support plans were looked at, to make sure that people’s health and personal care needs are being met in the way the person prefers. The plans cover each area of the individual’s care needs. They all contain information to guide staff in how to care for and support each person. Some people go to stay at the home for ‘intermediate care.’ This usually means they are recovering from a period of ill health and need time to get back into independent living, before returning home. Healthcare professionals assess the support people need to enable them to regain skills that have been lost or impaired due to illness. Their care plans include guidance on how the person’s support and care needs are to be met and healthcare staff visit regularly to work with people to help them regain skills, strength and confidence. There is a kitchen for people to use as part of their rehabilitation. This means people can practice skills that they may be having difficulty with, following their illness. The healthcare professionals can then assess people’s ability to carry out domestic tasks before they return home. The care staff at Richmond House said they receive training and advice on how best to support people who are staying for ‘intermediate care.’ When people go home the staff will continue to work with them, visiting up to four times a day, until the person is confident that they can manage. Staff will also stay with people for the first few nights, if the person would find this helpful. Many people also go to the home for regular respite breaks and one person lives permanently at the home. Their care plans include risk assessments and management plans where someone is at risk of falling, developing a pressure sore, becoming malnourished or any other area the staff feel may put the individual at any risk. Health care visits and treatments are recorded in detail and everyone who commented said they always receive the healthcare they need. There were two records in the plans that did not show what action, if any, had been taken to follow up on staff observations. One referred to a healthcare change and the other noted a behavioural change. The manager said she would follow these up straight away. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 13 We saw evidence that the plans are reviewed regularly, although one person’s daytime care plan did not have a record of the most recent review date. The plans include a ‘checklist’ for all the person’s care needs, which is completed when they first arrive at the home for a respite stay. This shows whether anything has changed since the person’s last visit. The plans for people receiving ‘intermediate care’ are developed using Health Authority documents. They focus on the individual’s healthcare and treatment. There was little information about the person and how they would like their care and support to be provided, outside of the rehabilitation treatment they received. As these people often spend several weeks at Richmond House, and most of their time is spent with the people who live at the home or are there for respite care, a separate plan for the areas not covered in the current plans may be beneficial. If the person, or their relatives, are willing to disclose information about themselves a life history can give staff a basis for understanding the individual better and help them to provide the person centred care the home. The medicines are kept safe and secure in locked cabinets. Some of the medicines are supplied by the pharmacy in a monitored dosage system, but many remain in the original packaging. We looked at the Medicines Administration Record (MAR) charts, which must show clearly the quantities of medicines received and in stock for each person, to make sure the records were accurate. The medicines supplied in the monitored dosage system appeared to be recorded accurately. The medicine trolleys were locked when unattended. The controlled drugs were securely stored and the records were accurate. The refrigerator used to store some medicines was checked on most days, to make sure the temperature was correct. We checked some of the medicines that were supplied in their original packaging, to make sure the numbers that had been signed as administered tallied with the amounts received and the quantities remaining. There were some inaccuracies in the MAR chart records, which the home’s management is following up with the staff responsible for administering medication. One person’s plan included a risk assessment for them taking responsibility for handling their own medication. Although it is a key feature of the person’s medical reviews, the assessment was dated in March 2007 when it was first completed. The assessment needs to show the dates of the reviews. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 14 During the visit, all the staff were seen to treat people with respect and maintain their dignity. The people who commented said that they receive the care they need and are supported to maintain their independence for as long as they are able. Everyone said the staff listen and act on what they say. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 are offered a variety of activities to take part in, if they wish. People are offered a good choice of meals to make sure their dietary needs and preferences are met. EVIDENCE: The home’s staff lead the activities and people take part or not as they wish. When we visited people were enjoying the relaxed, social atmosphere of the home and there was an armchair exercise session on the morning of our visit. A range of craft activities are offered as well as games such as scrabble, card games and quizzes. During the afternoon there was a lively game of ‘card bingo’, with prizes for the winners, and a singing session. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 16 People also enjoy singing with the new karaoke machine and the home has a ‘wii’, which people said they enjoy using for playing bowls. Some people get involved in planting the tubs of flowers that are put outside the front of the house in the summer. Many people also enjoy the beauty treatments that are offered. Entertainers visit the home and outings are arranged to places of interest. The home’s staff are planning to arrange more outings this year. A local church comes in regularly to hold a service for people who wish to attend. It may help staff to arrange other individual and group activities that people want if the care plans for people who stay for respite include a brief life history, with information about the activities they have enjoyed throughout their lives. The cook plans the menus to include the wishes of the people who are staying at the home and to meet any special dietary needs. There are always alternatives available if people do not want the choices on the menu. As well as a cooked meal at lunchtime, there is a choice of hot and cold dishes at teatime. People said that they enjoy the meals and the food is always hot when it is served. People are offered hot and cold drinks throughout the day and snacks are available at any time of the day and night. The dining tables were attractively laid and the dining room is light and airy. The mealtimes are relaxed and staff are available to help anyone who needs assistance. The people who go to stay at Richmond House said they can do what they want, when they want. This confirmed our observations that the staff support people to live their life in the way they choose. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 are aware of how to raise a concern or make a complaint if they are dissatisfied with the service. The majority of staff have received suitable training and staff understand the adult protection policies and procedures, which makes sure that people at the home are safe. EVIDENCE: Any complaints or concerns are recorded in a complaints file. The actions taken and the outcomes are recorded. Where needed, improvements would be made as a result of complaints investigations. Staff said they know what to do if anyone has concerns. The people who stay at the home said they know what to do if they have a concern or complaint. The home’s management are looking at other ways to encourage people to make comments about the home. There is a short comment card in the bedrooms for people to complete after their stay, if they wish. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 18 Newly employed staff are made aware of the homes whistle blowing policies and procedures, to be used if they suspect abuse or see examples of poor practice. The majority of the staff have had adult protection training, and the rest of the staff are taking this training very soon, to make sure they all understand fully how to protect the people who stay at the home. All the appropriate policies and procedures are in place to guide staff. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 home provides a clean, comfortable and well-maintained environment. EVIDENCE: The home is well maintained and everyone we spoke to said the home is always kept fresh and clean. All the rooms we saw were clean, bright and attractive. There is an ongoing programme of re-decoration in the house and the standard of décor was high. The rooms are comfortably furnished and have a welcoming feel. There are sufficient, accessible toilets and bathrooms on all floors of the house. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 20 A conservatory has been built which gives extra living space on the ground floor. As well as the downstairs lounge and dining room, there is a small lounge upstairs, which is useful if people want to take visitors there. The bedrooms are spacious and comfortable and have all recently been fitted with a flat screen television. One person said ‘I always enjoy my stay and the bedroom is always comfy.’ The first floor bedrooms are used by people who are staying for ‘intermediate care’. The doors are wider so that wheelchairs can pass through more easily and these rooms are larger than the downstairs bedrooms. They all have an en suite shower room and some of the rooms have adjustable beds, for people who need them. The home shares the services of a ‘handyperson’, who is employed to help look after the maintenance of the house and grounds. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient staff are employed to meet peoples needs. People are protected by thorough recruitment procedures, which ensure that staff are suitable to work with people who live at the home. Suitable training is provided to make sure staff have the skills and knowledge they require to be able to meet peoples needs. EVIDENCE: The staff rotas, and peoples comments, confirmed our observations that there are enough staff on duty to meet peoples care, social and leisure needs. In addition to the management team and the healthcare professionals, there are between three and five care staff on duty during the day and evening and two waking night staff as well as housekeeping and kitchen staff. This number seems to be sufficient to provide care and support for the people who stay at the home. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 22 The staff confirmed that staffing levels are adjusted to meet peoples needs and people who live at the home said there are enough staff on duty to support them. At the start of each shift there is a ‘handover’ from the senior staff who is going off duty, to the new senior. They detail how each person is and if there have been any changes in their health and well-being, as well as giving information on any people who have just arrived at the home. The homes recruitment procedures are thorough, making sure that staff are safe to work with the people who live at the home. All new staff complete an application form and provide two written references. Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks are obtained and no new staff begin work until these checks have been completed satisfactorily. All new staff complete induction training which meets the Skills for Care criteria. This gives them good basic training to help them do their job effectively, and provides a sound basis for taking a National Vocational Qualification (NVQ) course. Twenty of the twenty-five care staff have achieved an NVQ in care at level 2 or 3. There is also plenty of other training available for staff to keep their skills and knowledge levels up to date. The home keeps good records of staff training, which also shows when updates are needed. The staff said they receive all the training they need to do their job and they are also trained in how to support people who are staying for ‘intermediate care’ and are receiving rehabilitation support from Physiotherapists and Occupational Therapists. Staff have recently attended training courses on the implications of the Mental Capacity Act, including the deprivation of liberty, emergency aid, complaints handling and first aid. Fifteen staff have taken a level 2 course in nutrition and health at a local college. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 home is safe and well managed, in the best interests of the people who stay there. EVIDENCE: The manager’s role is shared by two registered managers. They both have the necessary experience and qualifications to manage the home, in the best interests of the people who use the service. The managers attend training to keep up their professional development. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 24 One healthcare professional said that the home is a ‘Well run, well managed, excellent care home.’ Since the last inspection the home now has the support of an administrator for a few hours each week. This has helped to free the two part-time managers and other senior staff from some of the reception and other administration duties. Additional administrator hours would give the home’s senior staff more time to spend on management and with the people who are staying at Richmond House. The records and the staff confirmed that all staff have one to one supervision meetings with their line manager. Supervision meetings support staff to plan their personal and professional development and give them the opportunity to discuss any areas of concern in a confidential setting. The staff said that they are well supported and they work well together as a team. Regular staff meetings are held and staff are encouraged to make their views known and contribute to the running of the home. Peoples personal information is stored securely when it is not being used. The homes policies and procedures are generally kept up to date; to make sure they provide relevant information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner, including fire safety training for the staff. These measures make sure that the health, safety and welfare of the people at the home is promoted and safeguarded. The laundry is well run and peoples personal clothing, as well as their bedding and towels, are properly cared for. Following their most recent inspection, the Environmental Health Officer has awarded the homes kitchen a maximum score of 5 stars, for hygiene and good kitchen practice. When we looked, the kitchen was well organised, clean and hygienic. The home has a range of quality assurance systems in place, to help determine the quality of service the home offers. These include surveys for the people who stay at the home, their relatives and other people with an interest in the home, staff meetings and regular audit checks. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 25 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 3 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X N/A 3 3 3 Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 26 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 OP31 Good Practice Recommendations The provider should consider further increasing the amount of administration support to the home. This will release senior staff from carrying out reception duties and other administrative tasks, and allow them to concentrate on their management responsibilities. Richmond House DS0000033217.V375429.R01.S.doc Version 5.2 Page 27 Care Quality Commission Yorkshire & Humberside Citygate Gallowgate Tyne and Wear NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.yorkshireandhumberside@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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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