Care Home: Risedale Rest Home Limited

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What the care home does well There are care plans in place which give staff good information about how each person`s care needs should be met. The health needs of the people living in the home are monitored by the staff and appropriate action is taken if there are any concerns. The staff are committed to providing good quality care and are well aware of the individual needs of the people they care for. The staff treat people with dignity and respect. Good relationships were apparent between the people living in the home and the staff on duty. The food is home cooked and people said they enjoyed the meals that were served to them. Visitors are welcome at any time and encouraged to take part in any events that are taking place. The atmosphere in the home is relaxed and friendly. What has improved since the last inspection? The manager has worked hard to update the care plans so they give good information about each person`s care needs. She is in the process of training each member of staff to use the care plans effectively. Good assessments are now carried out prior to people moving into the home to help ensure their needs can be fully met. The manager is developing a quality assurance system and is already carrying out audits on the care plans, people`s finances, environment, medication system, health and safety issues, staff training, staff supervision and staff files. Surveys are now issued to the people who live in the home and their relatives/representatives to ask their opinions of the service being offered. Hairdressing facilities are now provided in the home and a hairdresser visits on a regular basis. The home now has access to the internet which helps the manager and staff to keep up to date with developments and good practice. Staff supervision sessions are appropriately recorded so any issues can be followed up. What the care home could do better: Adequate facilities must be provided in the kitchen to ensure food preparation is hygienic to help protect people`s health and safety. People living in the home should be consulted on a regular basis and be offered more opportunities to access facilities in the local community. The complaints procedure should be mentioned in the service user guide to help ensure everyone is aware of this. The refurbishment programme should continue to ensure all areas used by the people living in the home are pleasant and comfortable. An appropriate smoking room should be provided to ensure all other areas are smoke free. The quality assurance system should continue to be developed to help raise and maintain the standards in the home. Key inspection report Care homes for older people Name: Address: Risedale Rest Home Limited 52-56 Percy Road Whitley Bay Tyne And Wear NE26 2AY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Anne Brown     Date: 1 6 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Risedale Rest Home Limited 52-56 Percy Road Whitley Bay Tyne And Wear NE26 2AY Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Risedale Rest Home Limited Type of registration: Number of places registered: care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: 1. The maximum number of service users who can be accommodated is: 17 2.The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places 11 Dementia Code DE, maximum number of places 6 Date of last inspection Brief description of the care home Risedale is a privately run residential care home situated in a residential area of Whitley Bay close both to the town centre and the sea front. The home provides personal care (but not nursing care) for up to twenty elderly people of both sexes. The Care Homes for Older People Page 4 of 27 Over 65 6 11 0 0 Brief description of the care home home is an older building, which has been adapted to provide care over three floors and was a pre-existing home at the time of the introduction of the National Minimum Standards. The premises at Risedale provide homely accommodation. However in common with many residential homes located within converted buildings, the design and layout presents some limitations for residents with physical disabilities. The street is on an incline therefore there are several short flights of steps to join different floor levels on corridors. Not all parts of the home could, therefore be accessed independently by people who have mobility problems or use wheelchairs. There is a passenger lift in place but steps still require to be negotiated to gain access to some bedrooms. The home has a small paved area at the front accessible via a step. There is a yard to the rear of the building. Weekly fees range from £422.90 to £438.63. Information about the home is readily available. Care Homes for Older People Page 5 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 2 star. This means that 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. How the inspection was carried out. Before the visit: We looked at: Care Homes for Older People Page 6 of 27 Information we have received since the last key inspection on 13th July 2009. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service and their relatives/representatives. Surveys returned by the people living in the home and the staff. An unannounced visit was made on 16th March 2010. During the visit we: Talked with people who use the service, staff, the manager and the proprietor. Looked at information about the people who use the service and how well their needs are met. Looked at other records that must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last inspection. We told the manager what we found. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Adequate facilities must be provided in the kitchen to ensure food preparation is hygienic to help protect peoples health and safety. People living in the home should be consulted on a regular basis and be offered more opportunities to access facilities in the local community. Care Homes for Older People Page 8 of 27 The complaints procedure should be mentioned in the service user guide to help ensure everyone is aware of this. The refurbishment programme should continue to ensure all areas used by the people living in the home are pleasant and comfortable. An appropriate smoking room should be provided to ensure all other areas are smoke free. The quality assurance system should continue to be developed to help raise and maintain the standards in the home. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 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 10 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 receive information to help them decide if they wish to move into the home and good assessments are carried out to help ensure their needs can be met. Evidence: The service user guide contains useful information to help people decide if the home is suitable for them and can meet their needs. The home carries out a pre-admission assessment which includes obtaining a care management assessment. The manager completes her own documents using a range of professionally recognised assessment tools, e,g, mobility, nutritional and social. This helps to ensure individual needs can be met and peoples preferences are discussed with them and recorded. Four case files were looked at and the assessment documents had been fully completed. Care Homes for Older People Page 11 of 27 Evidence: People are encouraged to spend time in the home to help them decide if their needs can be met and whether they would like to move in on a permanent basis. Care Homes for Older People Page 12 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. The care plans give staff very good information about the needs of the people living in the home and guidelines on how these needs must be met. This helps to ensure effective and consistent care is provided. Evidence: The care plans set out detailed care needs of the people living in the home and action plans are formulated to address them. The staff record information on a daily monitoring form which is evaluated monthly to help ensure any changing needs are fully met. Reviews are held on a regular basis or when it is necessary and all interested parties are invited to attend, with the permission of the person living in the home. The manager has introduced a programme for all care staff to receive training on an individual basis. There are suitable arrangements for meeting the health care needs of the service users. There are individual records of contact with health care professionals, including Care Homes for Older People Page 13 of 27 Evidence: GPs, psychiatrist, chiropody service, dentist, optician and other health care services. The home uses community nurses for advice for various health conditions. Risk assessments have been carried out on all aspects of people lives. The risk assessments are followed by risk management plans to help ensure that all staff are aware of how best to manage a particular risk. The staff on duty were aware of the individual needs of the people living in the home. They were observed to be treating them with respect and good relationships were observed. People are able to access their own bedrooms at any time and can choose how to spend their time. The senior staff responsible for the administration of medicines have completed safe handling of medication training. The home has proper arrangements for the storage and administration of medicines in the home. The administration system for medications was examined and there were no discrepancies. The effective drugs administrative system promotes the health and welfare of the people living in the home. 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 able to join in a range of activities provided in the home and staff escort them on outings whenever possible. Evidence: A range of activities take place in the home which include pamper sessions, videos, chair exercises, card games, bingo, hoopla, arts and crafts. Entertainers also visit on a regular basis. A record is kept of each persons activities and how they have spent their time. This helps the staff to introduce activities which will suit each persons preferences. Some people were involved in making small baskets for Easter and a party has been arranged. One person living in the home goes out every day with a support worker from the community. Another person, who is deaf, is supported by an external organisation to visit a club for people with hearing loss. A befriender visits two people on a weekly basis. Care Homes for Older People Page 15 of 27 Evidence: A church representative visits every month to offer Holy Communion. The staff on duty said they escort people to the local shops and cafes as often as possible. A survey returned from one person living in the home said the home should provide more activities and another person said they would like to go out more. A survey returned by a member of staff said the home should try to take people on outings a little more often. The home has an open visiting policy and visitors are welcome at any reasonable time. People are supported to keep in touch with their family and friends. Four weekly menus are in place. These are discussed with the people in the home and the manager ensures any suggestions are introduced to the menu. People said they enjoyed their meals and alternatives are available. The manager orders the shopping on a weekly basis and all food served is home cooked and prepared from fresh ingredients. 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. People living in the home are protected from abuse and any complaints are taken seriously. Evidence: The complaints procedure is displayed in the front hallway and a complaints book is maintained to record any complaints received and the outcome of the investigation. No complaints had been received since the last inspection. Several compliments had been received thanking the staff for the service they have provided. The staff have attended training on safeguarding vulnerable adults to help ensure people are protected from abuse. The manager confirmed that no safeguarding issues had been reported. The majority of surveys returned by people living in the home said they knew how to make a complaint but one person said they did not know how to do this. The service user guide does not mention complaints and the procedure to follow. Care Homes for Older People Page 17 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Generally people are provided with a pleasant place to live but some areas are in need of refurbishment. Evidence: Since the last inspection nine bedside cabinets, five bedside tables, bed and mattress have been purchased. Some furniture is still showing signs of wear and tear and the proprietor has produced a refurbishment plan to replace this and is planning to refit the kitchen. Each person living in the home has their own bedroom. These are personalised and reflects the interests and hobbies of each individual. Communal areas are clean and provide a choice of spaces for people to enjoy. There is a small backyard where garden furniture is provide so people can enjoy sitting out in the good weather. During a tour of the premises the following were noted:The mechanical ventilation system in the downstairs toilet was not working. Care Homes for Older People Page 18 of 27 Evidence: Some ceiling tiles were missing in two bedrooms and some wardrobe door handles were loose. The television in room 34 was placed on a chest of drawers and was not secure. This is a potential safety hazard. There are unpleasant odours in two bedrooms. The manager said the carpets were due to be steam cleaned. The door in room 35, kitchen and downstairs corridor were not closing fully on to their rebates and could pose a fire hazard. The manager has confirmed that the above issues were attended to the day after the inspection took place. The mattresses throughout the home have plastic protective covers and some people had blankets placed under the bottom sheet. The manager said this was to make them more comfortable but they tended to slip and curl up. The units and worktops in the kitchen are showing signs of wear and tear. Some areas of the worktops are wearing away and the shelves in the units are chipped. There are cracked tiles on the kitchen walls and floor. The grouting on the wall and floor tiles is dirty. This may not safeguard peoples health. The present smoking facilities for people living in the home are not suitable and do not conform with the smoke free legislation. The proprietor stated they intended to use an empty bedroom as a smoking room when this has been approved by the Environmental Services Department. The manager confirmed that the staff receive infection control training. Protective clothing is available and liquid soap and paper towels are provided to help prevent the spread of infection. A survey returned by a member of staff stated there should be stricter measures to ensure staff wore protective clothing when toileting. The manager stated that all staff were instructed to wear protective clothing when appropriate. Care Homes for Older People Page 19 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. There are enough staff, who have been properly recruited, to meet the personal care needs of the people living in the home. Evidence: At the time of the inspection the manager, two care assistants and cook were on duty. A policy and procedure supporting the recruitment and selection of staff is in place. A random sample of staff files was examined and these confirmed that Criminal Records Bureau checks and two written references are received prior to staff being employed by the home. Job descriptions and contracts of employment have been issued to all staff members. Mandatory health and safety training for staff has been updated. The staff have also received training from the community nurses on stoma and catheter care. Training courses have also been booked for Risk Assessment and Understanding Behaviour. The home employs 13 care staff. All the staff have completed NVQ (National Vocational Qualification) Level 2 and and eight have achieved NVQ Level 3. Three staff Care Homes for Older People Page 20 of 27 Evidence: have recently registered to achieve NVQ Level 3. The manager is provided one to one training with the staff on the care plans. Courses on Dementia Care, Deprivation of Liberty and the Mental Capacity Act are being sourced. Surveys returned by the staff all confirmed that they received good training. The people living in the home confirmed that they enjoyed good relationships with the staff and they were well cared for. When asked what the home did well comments included:Look after me. Care and attention. Care that I receive. Staff see that I am always clean and tidy - food is good. Care Homes for Older People Page 21 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 run in the best interests of the people living in the home and there are good systems in place to ensure their safety. Evidence: The registered manager has a number of years experience in working with older people and has completed the Registered Managers Award. She is currently undergoing training to achieve NVQ Level 4 in care and management. Regular meetings are held with the staff and the people living in the home. These are minuted and choice of food, activities and decor are discussed. The manager is developing a quality assurance system to ensure standards are maintained and improved. Regular audits are carried out on the care plans, peoples finances, environment, medication system, health and safety, training, staff supervision and staff files. Care Homes for Older People Page 22 of 27 Evidence: The manager has produced and issued surveys to the people living in their home but no report has been produced. Policies and procedures are in place for dealing with peoples finances. The staff in the home do not act as appointee or agent for any one living in the home. Money is deposited by people for safekeeping. A random sample of records and money held was examined. They confirmed that appropriate receipts and signatures are retained. The staff on duty stated that they meet with their manager to discuss how they were working. These sessions are recorded and the notes were available for inspection. Appropriate tests had been carried out on the fire detecting and fire fighting equipment. The home now have access to the internet which the manager finds useful to keep up to date with new legislation and best practice etc. to benefit the running of the home. Care Homes for Older People Page 23 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 24 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 1 26 16 Ensure that adequate 31/05/2010 facilities are provided for the preparation of food. This will help ensure peoples health and safety are protected. 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 12 Ensure that people living in the home are consulted on a regular basis and offered opportunities to use the facilities in the local community. Ensure that all the people living in the home are aware of the procedure to follow if they wish to make a complaint and this information should be included in the service user guide. Continue the programme to refurbish all areas of the home that are accessed by the people who live there. Ensure appropriate facilities are provided for people living in the home who wish to smoke. This should be in accordance with the smoke free legislation. Provide suitable mattress covers to ensure the comfort of Page 25 of 27 2 16 3 4 19 20 5 23 Care Homes for Older People 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 the people living in the home. 6 26 Ensure all members of staff are fully aware of the need to wear appropriate protective clothing to help prevent the spread of infection. The quality assurance system should continue to be developed and reports produced on the findings of the surveys issued to people living in the home and their relatives/representatives. 7 33 Care Homes for Older People Page 26 of 27 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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