Care Home: Riddlesden Rest Home

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What the care home does well The relatives of one person who has lived at Riddlesden for many years said the home is `Absolutely excellent`. They said that they are very satisfied with the care the staff provide and said that people`s health and well-being is improved through the good care they receive. They said staff treat people as individuals and always preserve people`s dignity. The people who live at the home said they are happy. They enjoy the activities and said the staff do what people want in the way people prefer. One member of staff said that `The service respects the service users` wishes and does not discriminate... All are treated the same`. The pre-admission assessments are thorough and make sure the home can meet people`s needs. Our observations confirmed that the staff understand the needs and preferences of all the people who live at the home. People`s health is looked after and the staff have the skills and experience they need to do this. One member of staff said that `District nurses, dietician and physio have all been brought in to improve (the) quality of care where needed`. Everyone said that staff listen to them, and act on what they say. Visitors said they are always welcomed. People are protected by safe and accurate medicines administration procedures. There is good and friendly interaction between the people who live at the home and the staff. There were enough staff on duty when we visited, to make sure they have time to spend with people in conversation, as well as supporting people to take part in individual and group activities. People said they enjoy their meals and there is a choice of dishes. People are offered drinks throughout the day. The staff are aware of people`s dietary needs and preferences. The kitchen and the rest of the house is clean and safe and there is a programme of maintainance and refurbishment work within the home. The complaints and adult protection systems work well and people said they feel safe and know what to do if they have a concern. What has improved since the last inspection? A new care planning system has been introduced which, when it is fully implemented, will make the care plans clearer and easier to follow and keep up to date. The range of activities that are offered has improved and people confirmed ourobservations that people are able to take part in interesting and meaningful activities, if they choose. The recruitment procedures are safe and make sure that no new staff are appointed unless all the necessary checks have taken place. Staff are offered a variety of training, to make sure they have the skills they need to carry out their role. Five of the seven care staff have a National Vocational Qualification in care. The home has installed a new nurse call system and completed other refurbishment and decoration work, in order to improve the environment for the people who live at Riddlesden Rest Home. What the care home could do better: The Service Users` Guide contains a lot of useful information, but some of the details need to be updated to make sure people are given accurate information. The home needs to continue with the programme of further improvements to the decor and furnishings that have been planned for the coming year, including making the laundry walls impervious. The manager needs to make sure that the regular programme of one to one supervision with her staff becomes a routine part of the home`s staff support and training programme. All the care plans and other personal information about people who live at the home must be stored securely, in order to be certain that people`s confidentiality is maintained. The owner/manager needs to continue to develop good quality assurance systems that will help her identify where improvements can be made. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Riddlesden Rest Home Carr Lane Riddlesden Keighley West Yorkshire BD20 5HQ     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: Liz Cuddington     Date: 0 7 0 1 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 27 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Riddlesden Rest Home Carr Lane Riddlesden Keighley West Yorkshire BD20 5HQ 01535604504 F-P01535604504 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Helen Leach care home 10 Number of places (if applicable): Under 65 Over 65 3 10 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 0 Riddlesden Rest Home is situated on the outskirts of Keighley. The home is a single storey adapted building, providing ten single bedrooms. There is car parking to the front of the building and good wheelchair access. The home does not have any gardens, but there is a fenced patio area at the back of the building that provides good views over the valley. The home is registered to provide care for up to ten men and women over the age of 65, the home can also provide care for up to three people aged over 65 with a diagnosis of dementia. Care Homes for Older People Page 4 of 27 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 quality rating for this service is two stars. 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 purpose of this inspection was to assess the quality of the care and support received by the people who live at Riddlesden Rest Home. The visit to the home was Care Homes for Older People Page 5 of 27 carried out over one day by one inspector. The previous key inspection was in January 2008. The methods used to gather information included conversations with the people living at the home, their relatives and the staff, as well as looking at care plans and examining other records. We received the homes self-assessment questionnaire just after the inspection visit. We also received questionnaires from some of the staff. These gave us a lot of useful information about the home. The fees are set at the local authority rate. There are extra charges for personal expenses. We would like to thank the people who live 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 care home does well: What has improved since the last inspection? A new care planning system has been introduced which, when it is fully implemented, will make the care plans clearer and easier to follow and keep up to date. The range of activities that are offered has improved and people confirmed our Care Homes for Older People Page 7 of 27 observations that people are able to take part in interesting and meaningful activities, if they choose. The recruitment procedures are safe and make sure that no new staff are appointed unless all the necessary checks have taken place. Staff are offered a variety of training, to make sure they have the skills they need to carry out their role. Five of the seven care staff have a National Vocational Qualification in care. The home has installed a new nurse call system and completed other refurbishment and decoration work, in order to improve the environment for the people who live at Riddlesden Rest Home. 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.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 8 of 27 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 27 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. People are assessed before they are admitted to the home, to make sure their needs can be met. Evidence: People said that they were given enough information about the home before deciding to move in, and they have also received a contract. The Service Users Guide contains a lot of useful information, but some of the details need to be updated to make sure people are given accurate information. Where possible the home encourages people and their families to visit the home and talk to the people who already live at the home, their relatives and the staff. The home invites them to come and spend time at the home, share a meal and maybe take part in the days activities. This means that the home can get to know the persons needs Care Homes for Older People Page 10 of 27 Evidence: and the individual has the information he or she needs to make a decision. The care plans included pre-admission assessments completed by the home. Before moving into the home, peoples needs are assessed to make sure that the home is able to meet their needs. This assessment forms the basis for the individual plan of care and support. Social Services assessments are included, when they are available. Care Homes for Older People Page 11 of 27 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. Peoples personal and healthcare needs are met. People are protected by the medication administration systems. Staff treat people with respect, care and consideration at all times. Evidence: Everyone we spoke to said the care and support is of a good standard. People and their relatives said that the staff do what the person wants in the way they prefer. They said they are very satisfied with the care and support they receive and feel that the staff understand peoples individual needs. One person said they would not want their relative to be anywhere else. Our observations also confirmed that the staff understand peoples care needs. Since the last inspection, a new care plan system has been purchased. The staff are gradually transferring all the information onto the new documentation, but the Care Homes for Older People Page 12 of 27 Evidence: previous documents are still available. When this is completed, the plans should be clearer and more straightforward to use and keep up to date. One member of staff said that the ...care plans are better than they used to be.... Three care plans were looked at, to make sure that peoples health and personal care needs are being met in the way each person prefers. The plans cover each area of the individuals care needs. They all contain enough information to guide staff in how to care for and support each person. The 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. The plans also include very informative life histories. These help staff to get to know and understand people better. The people themselves, and their relatives if they wish, are involved in reviewing and updating the care plans. The plans are all reviewed regularly by the staff, to make sure they still reflect each individuals care and support needs. The staff said they are kept up to date each day with any changes to peoples health and care needs. One staff member said the manager is always available for them to discuss any concerns with. People receive the medical and healthcare support they need and any concerns about peoples health are followed up. Detailed medical records are kept showing, for example, when the GP or the district nurse has visited and the outcome, as well as any further healthcare suppport that is needed. The medicines are kept safe and secure and the Medicines Administration Record (MAR) charts are securely stored. Most of the medicines are supplied by the pharmacy in a monitored dosage system, but some is kept in the original packaging. The MAR charts, which must show clearly the quantities of medicines received and in stock for each person, were examined. The medicines supplied in the monitored dosage system appeared to be administered and recorded accurately. There were signatures to confirm that staff had administered the medicine. The records of amounts received, administered and in stock of some medicines that Care Homes for Older People Page 13 of 27 Evidence: were supplied in their original packaging were accurate. There is a brought forward system in place, which makes it easier to check all quantities of medicines, to confirm that administration and the records are always accurate. 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. Peoples relatives confirmed this. Everyone said the staff listen and act on what they say. Care Homes for Older People Page 14 of 27 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 are supported to take part in a range of activities. People are offered a good choice of meals to make sure their dietary needs and preferences are met. Evidence: Everyone confirmed that people are supported to make their own decisions about all aspects of their life. On the day of our visit a music and health therapist visited. He goes to the home every two weeks, plays music and encourages people to take part in the exercises, which were fun and seemed to be enjoyed by everyone. Another practitioner visits regularly to work with individual people on exercises to help with falls prevention. Massage therapy for peoples hands, legs and feet is also offered. The staff spend time with people, talking and doing activities that people choose. Trips out are also arranged to places like Cliffe Castle and local garden centres. Care Homes for Older People Page 15 of 27 Evidence: People said they like the meals and thought they were very good with the right size portions to suit their appetite. The meals are planned to include the wishes of the people who live at the home and to meet any special dietary needs. Drinks are available throughout the day. At lunchtime there is a choice of either the main course and dessert that are on the menu, or an alternative if people prefer. Both the mealtimes and the menus are flexible, to suit peoples preferences. There is always food available for staff to make a snack for people during the day and night. One member of staff said that The meals are nutritious and flexible so that clients can have little and often if they want. The staff discuss the menus with people and make changes to meet peoples preferences. They try different dishes to see if people like them and will make sure meals are enriched for people who need this. The staff were knowledgable about peoples different dietary needs and make sure that special diets are provided for those who need them. People seemed to enjoy their meals and staff were on hand to discreetly assist people who needed some help to eat and to encourage people to finish their meal. Relatives confirmed that staff are always available to assist people. Drinks of juice and tea were provided at mealtimes. Conversations with people confirmed that the staff support people to maintain and meet their cultural needs. People are supported to attend religious services and follow their beliefs within the home, if they wish. On Wednesdays people are supported to attend a church service and social event, if they wish. Visitors are always welcomed to the home. There is a relaxed atmosphere and a good relationship between the people who live at Riddlesden Rest Home and the staff. Care Homes for Older People Page 16 of 27 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. The people who live at the home and their relatives said they are aware of how to raise a concern or make a complaint if they are dissatisfied with the service. Staff have received suitable training and understand the adult protection policies and procedures, which makes sure that people staying at the home are safe. Evidence: Any complaints or concerns are recorded in a complaints file. The actions taken and the outcomes are recorded. Staff said they know what to do if anyone has concerns. The relatives said the home responds appropriately to any concerns. People said they know what to do if they have a concern or complaint. 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. Most of the care staff have had adult protection training, and further refresher training is planned. All the appropriate policies and procedures are in place to guide staff. Since our last visit a number of anonymous concerns have been referred to Bradford Social Services Adult Protection team. These have all either been investigated, or are Care Homes for Older People Page 17 of 27 Evidence: undergoing investigation and adult protection staff are working with the home to make sure people are fully protected. Care Homes for Older People Page 18 of 27 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. The home provides a safe, comfortable, attractive and generally well-maintained environment. Evidence: The home is clean and generally well maintained and everyone we spoke to said the home is always kept fresh and clean. Since the last inspection a new nurse call system has been fitted. One of the bedrooms has been refurbished and others have been re-decorated. New carpet has been laid in the lounge/dining room. A new bathroom suite has been fitted and a shower with a seat has also been fitted. Further improvements to the decor and furnishings are planned for the coming year. The rooms are comfortably furnished and have a welcoming feel. There is a conservatory and outdoor seating for people to use in the better weather. The laundry is well organised and staff make sure that peoples personal clothing, as well as bedding and towels, are properly cared for. The laundry walls have been painted since the last inspection, to make them Care Homes for Older People Page 19 of 27 Evidence: impermeable and help prevent the spread of any infection. However, the underlying surface has not allowed the paint to adhere properly. The manager is obtaining quotes for washable panels that can be fitted onto the walls. Protective gloves, hand rub and aprons are available for staff to use, as part of their infection control measures. Care Homes for Older People Page 20 of 27 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. 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 and support needs. 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 the staff we spoke to said there is plenty of training available. They said it is good and keeps them up to date. The home keeps records of staff training, which also shows when updates are needed. Care Homes for Older People Page 21 of 27 Evidence: All new care 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. In addition staff attend training courses covering all areas of the general principles of care. Five of the seven care staff have achieved an NVQ in care. Other training courses that staff have taken include dementia care, epilepsy training, wound management and palliative care. The manager and the assistant manager have taken a longer, certificate course in equality and diversity. One of the training courses planned for the near future is on tissue viability. Care Homes for Older People Page 22 of 27 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 home is safe and run in the best interests of the people who live there. Evidence: The owner/manager has the experience and skills necessary to manage the home effectively, in the best interests of the people who live there. The records, and the staff, confirmed that all staff have just started to have regular one to one supervision meetings with their line manager again. This will support staff to plan their personal and professional development and give them the opportunity to discuss any areas of concern in a confidential setting. Because Riddlesden is a small home with a small staff group and the owner/manager spends a lot of time there, she also has regular, informal discussions with her staff. Peoples personal information is not stored as securely as it should be. All the care plans and other personal information about people who live at the home must be Care Homes for Older People Page 23 of 27 Evidence: stored securely, in order to be certain that peoples confidentiality is maintained. Where the home helps people to manage their personal finances, accurate records are kept of all transactions and all monies are securely stored. The homes policies and procedures are 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. The fire safety checks are carried out regularly and staff have had the necessary training and practice fire drills. These measures make sure that the health, safety and welfare of the people at the home is promoted and safeguarded. The homes kitchen had an inspection by an Environmental Health Officer the day before our visit. When we looked the kitchen was clean and well organised and new flooring has been laid since our last inspection visit. The home has some quality assurance systems in place, to help determine the quality of service the home offers. These include surveys for the people who live at the home and their relatives and staff meetings. Care Homes for Older People Page 24 of 27 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 25 of 27 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 1 The Service Users Guide needs to be updated, to make sure people are given accurate information. All the care plans and other personal information about people who live at the home must be stored securely, in order to be certain that peoples confidentiality is maintained. The owner/manager needs to continue to develop good quality assurance systems that will help her identify where improvements can be made. 2 37 3 38 Care Homes for Older People Page 26 of 27 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 © (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. 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