Care Home: Risedale At St George`s Nursing Home

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What the care home does well The home provides a high standard of health and personal care to people with complex needs and high levels of frailty. Care is delivered in an individual and person centred way, and people and their families are included and consulted in any decision making. People report high levels of satisfaction with this service. What the care home could do better: There were no requirements or recommendations made as a result of this inspection. The manager and staff continue to provide a very good service to the people who live in the home. Random inspection report Care homes for older people Name: Address: Risedale At St George`s Nursing Home Albert Street Barrow In Furness Cumbria LA14 2JB 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: 0 4 0 5 2 0 1 0 Information about the care home Name of care home: Address: Risedale At St George`s Nursing Home Albert Street Barrow In Furness Cumbria LA14 2JB 01229870050 01229822955 lonsdale.reception@risedale.carehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Joanne Robinson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Risedale Estates Limited care home 49 Number of places (if applicable): Under 65 Over 65 49 0 old age, not falling within any other category physical disability Conditions of registration: 0 49 The registered person may provide the following categories 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: - Old age not falling within any other category - Code OP Physical disability - Code PD The maximum number of people who can be accommodated is: 49 Date of last inspection Brief description of the care home Risedale Estates Ltd runs Risedale St Georges, and the registered manager is Joanne Robinson. The home is situated in the town of Barrow-in-Furness, a short distance from the shops and amenities. The home is purpose built with accommodation on two Care Homes for Older People Page 2 of 9 Brief description of the care home floors served by a passenger lift. All bedrooms are single with en-suite toilets. There is plenty of lounge and dining space and there are six bathrooms with specialist equipment. There is a pleasant garden area, with seating and a water feature. The home is twinned with Risedale at Lonsdale, and they share kitchen and laundry facilities, although the homes are managed separately. The general weekly fees at the time of this inspection ranged from £586.70 to £684.70 including any registered nursing care contribution entitlement. The home also caters for some people in receipt of continuing health care funding where individual fees are set in accordance with the specific number of care hours contracted. Information including the statement of purpose, service user guide and inspection reports can be obtained from the care home. 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 4th May. 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. We arrived just before mid day when people were starting to gather for lunch. There were 47 people living in the home and there were five nurses and ten care staff on duty. One of the nurses was doing her induction training and was extra to the normal staffing numbers. We also saw catering, domestic and maintenance staff going about their duties. The registered manager was present in the home. We looked at the care records for three people with different kinds of care needs. 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 the 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. 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 saw that peoples weight was monitored and professional advice was sought as necessary for people who had problems with weight loss. Records showed people had good access to outside health care and had seen their doctor, and other specialists such as chiropodist, physiotherapist and continence nurse as necessary. There were good records of any tests, including samples and swabs, along with the results and any treatment needed. People who completed our surveys told us they had been provided with enough information when they moved into the home, and that they received the level of care and support they needed. People also reported they knew how to complain if they needed to, and had someone they could talk to if they were worried. People said the staff listened to them, and confirmed the home was always fresh and clean. Here are some of the comments we received; Care Homes for Older People Page 4 of 9 They look after me well. The girls (staff) are nice. The staff are pretty good, they do everything for you. They keep the place warm and clean. My bedroom is comfortable, it is nice and warm and clean. One person thought there could be more staff at busy times. Staff surveys told us that staff felt well supported and received good quality training to help them do their jobs well. Staff surveys told us; We are well supported and have good training and development opportunities. They provide training to keep us updated and we have all the equipment we need. The home is managed brilliantly. The manager is always there to support and listen to staff. 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. 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 part of a medicine round in progress and saw the nurse followed good safe practice in administering medicines to people. Privacy and dignity was given a high profile in the home and was included in all staff training events. People kept their bedroom doors closed if they wanted and staff knocked before entering. All toilets and bathrooms had door locks fitted. Staff addressed people in a polite and respectful way using their preferred name or title. 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. One person had been supported to write an Advance Directive (or living will). The manager reported there had been no complaints or safeguarding matters in the last Care Homes for Older People Page 5 of 9 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. We looked around the home and saw it was was clean, tidy and fresh throughout, and people told us they were warm and comfortable. We saw lunch being served and heard people being offered choices and alternatives to the main menu. We saw the cook walking round the home in the afternoon chatting with people and listening to their views about the meal, and discussing future menu options. There was some building work in progress to install an additional lift and provide two new bedrooms. The work area was safely screened off from where people were living and although there was some noise disruption, this was being kept to the minimum. People had been kept informed about the work in progress. 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. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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