Care Home: Risedale At Aldingham St Cuthberts Nursing Home

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What the care home does well The home provides a high standard of health, personal and social care to people with complex mental health needs and high levels of physical frailty. Care is delivered in an individual and person centred way, and families are included and consulted in decision making. People report high levels of satisfaction with this service. What the care home could do better: There were no recommendations or requirements made as a result of this inspection. The manager and staff continue to provide a very good quality service to people living in the home. Random inspection report Care homes for older people Name: Address: Risedale At Aldingham St Cuthberts Nursing Home Risedale At Aldingham St Cuthberts Nursing Home Aldingham Ulverston Cumbria LA12 9RT three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jenny Donnelly Date: 2 8 0 4 2 0 1 0 Information about the care home Name of care home: Address: Risedale At Aldingham St Cuthberts Nursing Home Risedale At Aldingham St Cuthberts Nursing Home Aldingham Ulverston Cumbria LA12 9RT 01229869203 01229869152 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Jane Marie Harper Type of registration: Number of places registered: Conditions of registration: Category(ies) : Risedale Estates Limited care home 43 Number of places (if applicable): Under 65 Over 65 0 dementia Conditions of registration: 43 The registered person may provide the following category of service only: Care home with nursing: Code N, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Dementia: Code DE The maximum number of people who can be accommodated is 43. Date of last inspection Brief description of the care home Risedale at Aldingham St Cuthberts is a single storey, purpose built home for 43 older people suffering from dementia, and requiring nursing care. Risedale Estates Ltd operates the home and a new manager, Mrs Emma Smyth was appointed in January Care Homes for Older People Page 2 of 9 Brief description of the care home 2010. The home is built around a central square, which encompasses a secure garden to which residents have free access. There are 37 single and 3 double bedrooms, some of which have en-suite facilities. There are two large lounge diners, two smaller sitting rooms and one sensory room for people to use. There are five fully adapted bathrooms with specialist equipment. The home is located in the small hamlet of Aldingham, just of the coast road between Ulverston and Barrow-in-Furness, overlooking the Morecambe estuary. The sister home, Risedale at Aldingham, is adjoined to St Cuthberts and although the homes are managed separately they do share the kitchens and laundry. A statement of purpose and a service user guide is available from the home, along with the latest inspection report. Weekly charges at the time of this inspection ranged from £618.70 to £758.32. Care Homes for Older People Page 3 of 9 What we found: Prior to this inspection the lead inspector asked the manager to fill out a form called the Annual Quality Assurance Audit (the AQAA). This asks for details of what has improved in the home since the last inspection and for the plans for the coming year. This was fully completed and returned to us by the date we asked. We also sent surveys to some of the people who live in the home, their relatives and the staff. Their comments are included in this report. Based on the information provided in the AQAA, and the feedback received in our surveys, we judged the home was continuing to provide a safe service. We therefore decided to carry a short random inspection, rather than a full inspection at this time. Jenny Donnelly made an unannounced visit to the care home on 28th April. We (the Care Quality Commission) looked around the building and spent some time in the dining lounges to see was happening and to talk with people. We also spoke with the manager and some of the staff on duty. We looked at some care records and inspected the management of medicines. The focus of this inspection was health and personal care, and complaints and protection. When we arrived just after 9 am, some people were having their breakfast, whilst others remained in bed or were being attended to by staff. There were 43 people living in the home and there were three nurses and eight care staff on duty. We also saw catering, domestic and maintenance staff going about their duties. The manager was away from the home in a meeting, and returned for part of the inspection. We looked at the care records for three people with different levels of need, and met with them. We saw the care plans were very individual to the person and took account of their personal wishes and choices. This helped people receive care in a way, and at a time, that was acceptable to them. Care plans had been reviewed and updated each month, and where possible people had agreed to their plan of care. We saw there had been lots of family involvement where people lacked capacity to make choices for themselves. People who completed our surveys told us; This is an excellent home where my wife is very well looked after by compassionate and caring staff. They keep me informed of any issues affecting my relative and changes in her condition ... they have a good knowledge of people and respect the wishes of family. They spend time to help people with food intake and provide substitutes like smoothies to make sure people get good nutrition. One person said, They could pay more attention to personal appearance whilst another commented, Residents are always clean and tidy. Staff felt proud of the work they do and believed they delivered a high standard of care. Staff surveys told us; Care Homes for Older People Page 4 of 9 When a new person comes to live in our home we work together with them and their relatives to get to know them and to provide good care. When our residents go into hospital they always tell us they pleased to be home when they come back. Risk assessments had been documented for peoples moving and handling needs, skin care, nutritional needs and risk of falls. These had been updated monthly and plans put in place to reduce any identified risks. We looked at management of wound care and saw there were detailed wound assessments, and clear treatment plans in place. Wound care specialists had also been consulted for advice. People who needed them, had pressure reducing mattresses and seat cushions. We saw that peoples weight was checked and people who experienced weight loss were monitored more carefully and professional advice was sought as necessary to help them maintain a healthy weight. Records showed people had good access to outside health care and had seen their doctor, and other specialists such as dietitian, physiotherapist and speech and language therapist as necessary. We looked at the management of medicines and saw all nurses completed comprehensive medicines training. There were written guidelines in place covering the ordering, receipt, storage, administration and disposal of medicines. The medicines records were clear and correct, and the storage was secure. We checked some individual medicines and found the amount administered and the remaining tablets tallied with the amount supplied. We saw that medicines due at odd intervals, such as alternate days, once a week or in variable doses were well managed. Medicines with a short shelf life had been marked with the opening date so staff knew when to dispose of them. There was a homely remedy policy in place which meant people could have simple over the counter remedies without having to wait and see their doctor first. We observed a medicine round in progress and saw the nurses followed good practice, and were careful and patient in helping people take their medicine. Privacy and dignity was given a high profile in the home and was included in all staff training events. Staff knocked on bedroom doors before entering and people who shared twin rooms had their privacy maintained by the use of curtains or screens across the room. All toilets and bathrooms had door locks fitted. We heard staff addressing people in a polite and respectful way. The Risedale group has implemented the NHS Gold Standard Framework for end of life care and staff have been trained in palliative care. The group employ an end of life care nurse specialist, and nursing staff have been trained in the use of syringe drivers, core drugs and are able to verify death. We saw that end of life care wishes had been discussed with people or their family, and their wishes documented. The home used the NHS Preferred Priorities of Care document, so people could have a record of their wishes that would be respected by all health and social care staff even when the person was no longer able to speak for themselves. The home employed an activity organiser and we saw her working with individuals and small groups throughout our visit. We observed her looking at a magazine with a person and chatting about every day things and the memories inspired by the articles and pictures. We later saw a small group engaging in a word quiz. We saw from peoples care Care Homes for Older People Page 5 of 9 records there had been baking sessions, singing, holy communion and crafts. The manager reported there had been no complaints or safeguarding matters in the last year and none had been made to the Care Quality Commission either. There was a complaints procedure on display and a copy was given to every person and their family when they moved into the home. Staff attended annual training on safeguarding procedures which covered recognising abuse and how to report anything they see or hear that concerns them. The home was clean, tidy and fresh throughout. Domestic staff were going about their cleaning duties and beds were being stripped and changed. Some bathrooms were in use, the others were clean and tidy. One survey told us; The home is always clean and tidy and well decorated. A new home manager Mrs Emma Smyth was appointed in January 2010. She was previously a senior nurse in the home, and was in the process of applying to the commission to become the registered manager for this service. Staff surveys told us; The home is extremely well run, I am glad to work here. New ideas are discussed and we improving all the time. We have good training and learning resources. What the care home does well: 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 2. Care Homes for Older People Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 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, 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 Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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