Care Home: Ridgeway Care Home

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What the care home does well People who have decided to move to Ridgeway can be sure that a full assessment of their needs will be done thoroughly.There is a stable group of staff who know the residents well. Staff spoken to have a knowledge and understanding of the residents. The care staff on duty talked and interacted with the residents in a respectful and caring way. The residents are encouraged and supported to do as much as possible for themselves. The home does meet the physical and healthcare needs of the people who live there. There is input from the local specialist team and G.P appointments are frequent. Any complaints or concerns are taken seriously and acted on. Each of the residents has their own rooms, which are personalised and reflect their individual tastes and choices. People living at the home can be sure that their views will be taken into consideration and acted on. The Home has a Quality Assurance System in place for the benefit of the residents. What has improved since the last inspection? The home has new manager in post. At the time of the visit she had only been in the home for a few weeks but it was reported and demonstrated that she is able to give support, direction and guidance to the residents and the staff group. She is working towards ensuring that the aims and objectives of the home are met and that the residents receive the support and care they need. The home now has a full complement of staff so the home now has the resources to ensure that the residents are offered choices about how they live their lives. What the care home could do better: All the information about supporting the residents and meeting their individual requirements needs to be brought together. This will ensure a person centred approach and planning is developed and promoted.The service needs to make sure that people living at the home have an individual activities programme, which is implemented. This will help residents live a fulfilling and active life. Activities need to be developed to meet individual goals and aspirations. The manager needs to make sure that there is guidance and direction in place for staff who administer medication to residents on a `when required` basis. All staff need to have training that is up to date and on going to support the residents specific needs. The manager needs to ensure that the staff are learning and improving their skills and knowledge. The residents need to have easy access to information about the home. The service also needs to display information on how people make a complaint. This needs to be written in a format that is understood by the people who live at Ridgeway. The front of the house needs to be repaired as soon as possible to ensure the safety of the residents and to maintain the property to a good standard. The manager does need to review the company`s generic policies to ensure that specific to the residents who live at Ridgeway. CARE HOME ADULTS 18-65 Ridgeway Care Home 11 Park Avenue Gillingham Kent ME7 4AS Lead Inspector Mary Cochrane Unannounced Inspection 28th January 2008 09:30 Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ridgeway Care Home Address 11 Park Avenue Gillingham Kent ME7 4AS 01634 851443 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) ridgeway@ilg.co.uk Independent Living Group Vacant post Care Home 8 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (2) of places Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th May 2006 Brief Description of the Service: Ridgeway Care is a large semi-detached property, providing accommodation on three floors. It is located in a residential area, opposite a large park and within walking distance of shops. Public transport is easily accessible. The home provides care and support to adults with learning disabilities and challenging behaviour. They are registered for 8 service users, but at present there are six people living in the home. Since the last inspection the Home has changed hands and is now managed by Independent Living Group Limited. The service has a new manager in post. She manages the home on a daily basis and also works 16 hours a week as part of the care staff team. The home employs eleven care staff. The charges for services currently range from £700.00 to a £2000.00 per week approx. depending on needs. A copy of the latest CSCI report is available at the office or on the CSCI website. Ridgeway Care Home DS0000066240.V358006.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 2 star. This means the people who use this service experience good quality outcomes. This visit to the Service was an unannounced “Key Inspection” which took place over one day. All the core standards were looked at during the visit. This visit forms part of the key inspection. The home had not received an Annual Quality Assurance Assessment (AQAA) from the commission therefore information could not be used from this report. The following methods of inspection and information gathering were used: At the time of the site visit there was one-to-one discussion with people who use the service, care staff and management. Staff interactions with residents, care interventions and activities were observed. Individual support plans risk assessments were discussed. Selected policies, medication charts, training matrix and training programmes and financial arrangements were looked at. There was in depth discussion with the manager during the site visit. A partial tour of the building was undertaken. Information received from the home since the last inspection was used in the report. Surveys were obtained from some of the people who use the service and some of the staff. On the whole comments received about Ridgeway were positive. We also looked at information we have about concerns and complaints and how these have been managed. Since the last inspection the service has raised 2 safe guarding adults alerts. these have been dealt with appropriatly by the home and the local adult protection team. We also took into account the things that have happened in the service, these are called ‘notifications’ and are a legal requirement. What the service does well: People who have decided to move to Ridgeway can be sure that a full assessment of their needs will be done thoroughly. Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 6 There is a stable group of staff who know the residents well. Staff spoken to have a knowledge and understanding of the residents. The care staff on duty talked and interacted with the residents in a respectful and caring way. The residents are encouraged and supported to do as much as possible for themselves. The home does meet the physical and healthcare needs of the people who live there. There is input from the local specialist team and G.P appointments are frequent. Any complaints or concerns are taken seriously and acted on. Each of the residents has their own rooms, which are personalised and reflect their individual tastes and choices. People living at the home can be sure that their views will be taken into consideration and acted on. The Home has a Quality Assurance System in place for the benefit of the residents. What has improved since the last inspection? What they could do better: All the information about supporting the residents and meeting their individual requirements needs to be brought together. This will ensure a person centred approach and planning is developed and promoted. Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 7 The service needs to make sure that people living at the home have an individual activities programme, which is implemented. This will help residents live a fulfilling and active life. Activities need to be developed to meet individual goals and aspirations. The manager needs to make sure that there is guidance and direction in place for staff who administer medication to residents on a ‘when required’ basis. All staff need to have training that is up to date and on going to support the residents specific needs. The manager needs to ensure that the staff are learning and improving their skills and knowledge. The residents need to have easy access to information about the home. The service also needs to display information on how people make a complaint. This needs to be written in a format that is understood by the people who live at Ridgeway. The front of the house needs to be repaired as soon as possible to ensure the safety of the residents and to maintain the property to a good standard. The manager does need to review the company’s generic policies to ensure that specific to the residents who live at Ridgeway. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 People who use the service experience good outcomes in this area. People can access information about the home to help them make an informed decision as to whether it’s the right place for them to live. All individuals have had an assessment to make sure the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a statement of purpose and there is a service users guide in each of the residents care files. These documents have information about the facilities and services the home has to offer. The service users guide is well written and informative. It includes how to make a complaint. The people living at the home would benefit from having easier access to the guide. There are some pictures in the guides but it could be further developed into different formats so it is more understandable for the people who use the service. It would also benefit from including the views of the people living at the home. The manager said she would address this. The home has had one new admission since the last inspection. The service has all the necessary tools in place to undertake a good assessment. The assessments look at all the different levels of need and support. They contain Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 10 the necessary information for developing care plans. A good range of information was obtained before a decision to offer a service was made. Assessments are also obtained from care management teams and information from these is used when developing care plans. The service told us that only a member of staff with the necessary skills and knowledge would undertake an assessment. Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,and 9 People who use the service experience good outcomes in this area. Residents have individual care and support plans that ensure their needs are identified and met. They are supported to take assessed risks as part of an independent lifestyle and to make decisions in their lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each of the people living at the home has a care plan. 3 care plans were looked at in detail. They are of a good standard and reflect the individual and changing needs of the residents. The plans do contain all the necessary information on the action that is required to ensure that needs are met. They also contain information on likes and dislikes. There are also plans on, eating and drinking, personal hygiene care, medical and specialist needs, and individual management. The plans do identify challenging behaviours but not Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 12 all the plans explain how to manage the behaviours safely. Staff spoken to were able to explain how they would do this. The new manager is in the process of arranging 6 monthly care management reviews for all the residents but some resident’s reviews are outstanding. The staff at the home do review the care plans monthly. Each of the residents has designated a key-worker who is involved in planning and reviewing care and support with the individual resident. There is a lot of paper work in place for each resident so much so that it is difficult to find information easily. Information on care and support is kept in various files and in different areas of the home. All the information about the residents needs to be brought together. This will ensure that the person is being cared for in a holistic and person centred way. It will also ensure that nothing is overlooked or missed. The residents and staff need to be able to use the plans as a daily working tool. Staff said due to the fact they have different managers over the past year there have been many changes in the care planning system and they keep being told different ways of doing things. They hope with a new manager in post this issue will now be resolved. Daily records contain good and relevant information to show how the residents have made choices and decisions. It was possible to cross reference information to show that care plans and risk assessments are being used to provide the necessary care. Through observation, talking to residents and staff and from looking at the documentation there was evidence to support that people are involved in making decisions on how they live their life’s. Any limitations and restrictions are recorded in the individuals care plan. It was seen that staff listened to what the residents want and acted on this. There are regular residents meetings and these are recorded. The residents said that their views are listened to and acted on. There was evidence available to show how people choose their meals, how they choose what they want to do and where they want to go. Staff said they would like to help the residents become more independent. They felt the new manager would promote this for the people who live at the home. Risk assessments are in place but are kept separately to the care/ support plans. Some of the risk assessments need to contain more direction and guidance on how to manage risks while enabling the residents to live a safe and independent life. Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 15,16 and 17 People who use the service experience good outcomes in this area. People living at the home have an appropriate and life-style both in-side and out-side the home. This could be enhanced and improved. The residents are offered involvement and choice in a varied and healthy diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each of the residents has an individual activities programme. 3 of these programmes were looked at and cross-referenced with the daily records. At the time of the visit it was evidenced that although the programmes are in place planned activities were not taking place regularly. The new manager had already identified this shortfall. She told us that she is going to discuss activities with each of the residents and develop programmes according to their likes, dislikes and preferences. She says that the home now has enough staff to ensure that planned activities take place. Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 14 One resident said ‘ I don’t want to go out, I want to do things in the house’. Another said ‘ I want to go swimming more’. There was no recorded explanation as to why planned activities did not occur and what alternative was offered instead. Staff were able to give a verbal account of why activities had not happened. Staff need to ensure that this information is documented and accurate records are kept. On the day of the visit residents who wanted to be were engaged in various activities, those who wished to spend time in their rooms were able to do so. Some residents were drawing and some were doing craftwork. They said that they enjoyed doing this and were keen to show what they had achieved. Some residents attend a local day centre on a regular basis and others go out for walks or shopping. Some of the residents regularly go to an evening social club. The home does plan staffing levels around what the residents want to do. Residents are encouraged to maintain contact with their family and friends. Everyone who wanted to had a holiday last year. Residents said they had a really good time and were looking forward to going away this year. The residents are involved in the daily routines of the home and are encouraged to take care of their own rooms and are involved in preparing meals and drinks. The residents said they can choose when to be in the privacy of their own rooms or in the communal areas. Residents do not have keys to their own rooms. Keys are available but residents have chosen not to use them. There is evidence in place to support this. The residents have the freedom to access all communal areas of the home. Members of staff were observed demonstrating good body language and communication skills when interacting with the residents. They were seen to talk and interact in a positive way and involved and included residents in conversations. The home told us they have a set menu but choices are given at every meal time. Mealtimes at the home are flexible. A record is kept of the meals eaten so any problems can be identified quickly and acted on. Residents have access the kitchen whenever they want. They have access to drinks and snacks and assist in preparing and cooking meals. Residents said that they enjoyed their mealtimes and the food is good. Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 15 Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 People who use the service experience good outcomes in this area. The service ensures that residents benefit from having their physical and emotional and health needs met. They are given personal support in a way that they prefer and require. Residents are protected by the home’s medication policies and procedures for dealing with medicines. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service operates a key worker system to provide sensitive and individual support to the residents. Personal care, life skills and dignity are promoted. Residents choose their own clothes and are supported to shop. Residents and staff told us that support with personal care was offered appropriately and sensitively. There is a flexible approach to daily living activities e.g. getting up, bed, bath and mealtimes. Staff were seen to approach residents a caring Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 17 and supportive manner. It was observed that the resident’s privacy and dignity is maximised allowing them independence and control of their own lives. Each resident health care needs are recorded in their care plans. Some of the residents have complex health needs. The service was able to evidence that these are well managed. There is information in the plans, which highlights early warning signs of identified health needs, this enable staff can take immediate and appropriate action. The manager is in the process of transferring this information onto new documentation. This should make it easier to access relevant information and ensure all health needs are identified, met, monitored and reviewed at the required intervals. The home ensures that the residents have access to healthcare facilities and routine checks are carried out. Resident’s health care needs are carefully monitored and there is input from local specialist teams when necessary. The service told us that all residents have had an annual health check from the local GP surgery. A medical report sheet is kept up to date evidence dental, chiropody, G.P. and other health care appointments. The home uses a Monitored Dosage System (MDS) from Boots and all staff who administer medication have received appropriate training. One staff member has done extended 12 week training and was able to demonstrate a good knowledge of the residents’ medication and related side effects. The MDS packs were cross-referenced with drug dispensing sheets and at the time of the visit these tallied. A drug round was observed and this was done safely. All drugs administered had a written prescription in place. The registered manager ensures that medication is regularly reviewed and changes are reflected in the individuals care plan. Audits have commenced take place to ensure that medication is given correctly and procedures have been adhered to. The manager needs to ensure that staff competencies are regularly checked. The service does need to develop clear written protocols and guidance in relation to medication to be administered as and when required. This will give staff direction and guidelines on when administer ‘as required’ medication. This also needs to include topical creams. This will ensure that residents are receiving medication in a consistent way and when they need it. Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good outcomes in this area. The home has a satisfactory complaints system and residents are protected from harm and abuse This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home does have an open culture and residents are encouraged to express their views and concerns. Views are sort on a regular basis both in meetings and on a 1:1 basis. Views are recorded and acted upon. There is a complaints procedure in place, which meets all relevant requirements, and each resident has a copy in their service users guide. However the residents need easier access to this information and it needs to be in a format that they can understand. The complaints procedure needs to be displayed in prominent areas within the home. This was discussed with the manger at the visit and she is going to make sure this information is available. The residents spoken to were aware of what to do if they did have a complaint. They said that staff did listen to them. The home understands the procedures for safe guarding adults and has been pro-active in raising safe guarding adult alerts. The service has reported 2 adult protection issues since the last inspection. Immediate and appropriate Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 19 action was taken to deal with the situation. One of the safe guarding issues is still being investigated and remains open to the local adult protection team. The home has an adult protection and whistle blowing policy. Some staff have received safe guarding vulnerable adults training. The manager is in the process of arranging the training. Staff competency also needs to be regularly tested in this area. The service has evidence to demonstrate that the resident’s finances are managed appropriately and safe guarded. The home has developed systems of managing resident’s personal monies, which protects them from abuse. Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27 and 30. People who use the service experience good outcomes in this area. The home provides an environment that is appropriate to the needs of the people who live there. On the whole Ridgeway is homely, comfortable, safe and clean. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A partial tour of the premises was undertaken and it was evident that the inside of the home is maintained to a good standard. The bedrooms seen were well decorated and furnished. They were individual and reflected the personalities of the people who live at the home. There are 2 bathrooms in the house. The bathroom on the first floor one has been up-graded, but the bathroom on the second floor does need refurbishing. Both rooms could be made more homely and welcoming. There is a bath aid in place to assist residents who need help in and out of the bath. Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 21 On the day of the visit the front garden of the home was sealed off for safety reasons. Apparently the fascias of the house have been deemed unsafe. Repair work was due to start within the next couple of weeks. The company needs to make this work is completed as soon as possible. The home is kept hygienically clean and there are no unpleasant odours. Residents are encouraged to clean their own rooms with assistance and support from staff. The laundry room was orderly, and in line with the standard. Staff do all the washing. The manager did not know why residents were not involved with this activity. Any soiled laundry is transported safely and washed in red bags according to the homes procedures. Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33,34,35 and 36. People who use the service experience good outcomes in this area. The staff have a good understanding of the people living at the home. Positive relationships have been formed. On-going training needs to be in place to make sure the staff have the competencies and skills to meet all the needs of the residents. Recruitment practises protect the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff reported that they have developed good relationships with the residents and are able to anticipate and meet the individual needs of the client group. The residents responded positively and openly to staff. It was observed that the staff are accessible and approachable. It was evidenced that the staff on duty put the needs of the residents first. Some of the staff have worked at the home for a reasonable length of time and have a good knowledge and understanding of the residents. Residents said that they like the staff and get on well with them. Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 23 During the past year the care staff have had to work in difficult circumstances and adapt to the ways of different managers. At all times the needs of the residents have been but first. In the absence of a manager the senior carers at the home have ensured the needs of the residents have been meet and they have ensured that good standards have been maintained. They should be commended for this. The care staff have also reported the start of a good working relationship with the new manager. Although wary, staff reported that they feel confident and optimistic about the future of the service. The home employs 11 care staff of varying skill. To date 9 members of staff have completed their NVQ level 2. The home has a training matrix and shortfalls were identified in areas of staff training. From looking at the evidence it was seen that some staff have not received the required up dated mandatory training even though they have been at the home for a considerable period of time. There are also gaps in specialist training. Staff need to gain the knowledge and skills they require to undertake their role effectively, efficiently and safely. The home needs to ensure that this shortfall is addressed and that training is planned and on – going. The management of the home needs to make sure that staff competencies are checked at regular intervals. The manager told us the home has just reached its full complement of care staff. Extra staff are included on the duty rota when needed. There is often extra staff on in the evening to ensure that residents can go out. The amount of staff on duty depends on the needs and plans of the residents. The service does have a thorough recruitment practises. The sample of files looked at contain all the necessary information to ensure that the residents are protected. The acting manager now ensures that a full employment history is obtained from all prospective staff and that any gaps are explored at interview. The service told us that staff meetings are held, evidence of this was seen during the inspection. The new manager plans to have these more regularly. All staff have regular supervisions and appraisals booked in advance. Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 People who use the service experience good outcomes in this area. The home has a new manager in post who has the necessary qualifications, experience and skills to offer leadership guidance and direction. The home is well run and in the best interest of the people who live there. The health, safety and welfare of the residents is promoted and protected This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of the inspection the manager of the home had only been in post for three weeks and was still in the process of finding out about the residents, staff and how the home functions. She had already gained insight and knowledge into the strengths and weaknesses of the service. The manager was Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 25 working in a sensitive and thoughtful way to ensure that she develops a trusting and open relationship with the residents and staff. Staff and residents were positive about the new manger and felt that she would be able manage in the home in the best interest of the people who live there. The manager has the knowledge skills and qualifications to run the effectively. The home did not receive an annual quality assurance assessment (AQAA) from the commission prior to the inspection. Therefore information from this could not be used in the inspection process. The home has developed effective quality assurance and monitoring systems. They told us they have a quality assurance audit files, which include audits in medication, finances, health action and health and safety. Questionnaires have been sent to residents, care managers, relatives and staff. The results of these questionnaires have been collated so that the strengths and weaknesses of the service can be identified. The manager can now make plans on how to further develop and improve the home. The results of the survey need to be published and made available to the residents. Effective quality assurance and monitoring systems l measure the success of the home in achieving its main aims and objectives. The home provides a safe environment for people to live in and staff to work in. Good working practices ensure the home is free of hazards. The home has informed us that maintenance checks are up to date. They have reviewed fire safety and new fire risk assessments are in place. The required checks are done. Water temperatures are monitored regularly. All staff need to be up to date with mandatory training. Training needs to be on- going. Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA35 Regulation 18(1)(c) Requirement The home needs to ensure that mandatory training is up-to date for all staff. The home also needs to ensure that all staff receive more specialist training to ensure that they have an understanding and knowledge of residents conditions and how to best meet individual needs. Timescale for action 31/05/08 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 YA6 Good Practice Recommendations The files and care plans need to be brought together and streamlined so they can be used as an effective and efficient working tool for residents and staff. To ensure that activities programmes are developed with each resident and they receive the supported and guidance they need to undertake the activities. The service does need to develop clear written protocols and guidance in relation to medication to be administered DS0000066240.V358006.R01.S.doc Version 5.2 Page 28 2 3. YA12 YA20 Ridgeway Care Home 4. 5. YA22 YA41 as and when required. The service needs to ensure that the complaints procedure is prominently displayed in the home and is in a format that residents can understand. It is recommended that the manager review the new organisations generic procedures to ensure they meet residents’ local needs. Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Oxford Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ridgeway Care Home DS0000066240.V358006.R01.S.doc Version 5.2 Page 30 - 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. 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