Care Home: Risedale Retirement and Residential Home

Similar services:

• Chirnside House
• Chirnside House
• Keer Sands Residential Home
• Rosehill Residential Home
• Ruskin Lodge
• Ruskin Lodge

What the care home does well We judged that Risedale was providing an excellent service to people. The service had good assessment and admission procedures which helped people to know if the home would be able to meet their needs. The planning and delivery of personal care was very individual and met with people`s expectations and wishes. There were good arrangements in place for people to access external health care and advice. People told us; "The carers are marvellous" "The carers are very good, everything is fine, we are quite happy here" "Everyone gets bathed regularly and clothes and bedding are changed frequently". The home was sufficiently staffed to meet peoples` needs, and all grades of staff received good quality training suitable to their role. Staff felt they were supported to do their jobs well. Recruitment procedures were robust to ensure only suitable staff were employed. People were happy with the range of activities and entertainment provided, and these were tailored to suit individual needs and wishes. One person said; "There is always something going on if you want to join in, and there is no pressure to do it if you don`t want to". The provision of meals was praised, with plenty of choice and a good variety of foods served. Special diets were catered for and staff supported people who needed help to eat and drink. The home was well maintained, clean and comfortable. Infection control procedures were good and people were very pleased with the standard of accommodation and laundry arrangements. "My clothes are taken and come back the next day nicely ironed and all on hangers" "They are in here every day cleaning my bathroom and toilet, it`s spotless". The service had a very low incidence of complaints, but was able to demonstrate they listened to people and took any concerns seriously. Staff were knowledgeable about safeguarding procedures and understood their role in protecting people from harm. People told us they felt safe in the home. The service was well managed, and sought out people`s views through quality surveys, residents` meetings and individual discussions. There was evidence that people`s suggestions and comments were acted on. There were good health and safety arrangements in place to keep the home safe for people to live and work in. What has improved since the last inspection? Since the last inspection there has been ongoing redecoration and general refurbishment work at Risedale. All corridors and communal rooms had been fully decorated and had new flooring and curtains provided. There was new dining room furniture and new televisions in the lounges. An additional en suite bedroom had been provided on the Ivy unit. There was a new fire alarm and nurse call system in place. The home had implemented the NHS Gold Standard Framework for end of life care and the Dignity Challenge. Staff had received training on this, and other training had continued with some other new subjects such as Mental Capacity Act and Deprivation of Liberty Safeguards being added. Training materials in all subjects were routinely updated to ensure staff were taught current best practice. The home had increased the number of care staff with a National Vocational Qualification (NVQ) in care to 84%. Through consultation with people the menus had been altered and there were plans to resurface the car park, and to refurbish the Ivy unit. What the care home could do better: No requirements or recommendations were made following this inspection. The manager and staff continually monitor the quality of the service, and make improvements by listening to people who use the service, and by keeping up with professional developments. Key inspection report Care homes for older people Name: Address: Risedale Retirement and Residential Home Abbey Road Barrow In Furness Cumbria LA14 5LE     The quality rating for this care home is:   three star excellent 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: Jenny Donnelly     Date: 0 7 0 4 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 30 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 30 Information about the care home Name of care home: Address: Risedale Retirement and Residential Home Abbey Road Barrow In Furness Cumbria LA14 5LE 01229839669 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Risedale Estates Limited Name of registered manager (if applicable) Mrs Pamela Harper Type of registration: Number of places registered: care home 69 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 69 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 Dementia - Code DE Physical Disability Code PD Date of last inspection Brief description of the care home Risedale Retirement and Residential Home is run by Risedale Estates, which operates five other care homes in the area. The registered manager is Mrs Pamela Harper. The home is a two-storey building, which has been extended and modernised to suit its Care Homes for Older People Page 4 of 30 Over 65 0 69 0 69 0 69 Brief description of the care home present use. It is situated on Abbey Road in Barrow in Furness, with easy access to public transport and local shops. The full town centre amenities are quite close by. The home provides residential care for older people and for people with physical disabilites. There is a separate dementia care provision within the home called The Ivy Unit. The home has sixty seven single bedrooms, and one double bedroom for a married couple. The majority of bedrooms have full en-suite facilities, including an assisted bath or shower. For the rooms without private facilities there are ample communal bathrooms and toilets. There are a number of dining and lounge areas for people to use. There is a nicely landscaped garden with pleasant seating areas, and a secure garden for the Ivy unit. The weekly fees currently range from £398.00 to £515.00 per week according to care needs. Detailed information about the services and facilites offered is available by request from the care home, along with copies of previous inspection reports. Care Homes for Older People Page 5 of 30 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: three star excellent 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: This was the main or key inspection for the year. The lead inspector Jenny Donnelly 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 and to the staff. We received nine completed staff surveys and ten from people living in the home. Jenny Donnelly made an unannounced visit to the care home on 7th April between the hours of 09.30 and 15.30. During this visit we (the Care Quality Commission) toured the building and spent time in the lounges and dining rooms where we watched meals being served. We spoke with people living in the care home and their visitors. We also spoke with a visiting district nurse, the senior carers and other staff on duty. We looked at files and documents that backed up what we were told and what we saw. Care Homes for Older People Page 6 of 30 Since the last key inspection in May 2007, we have completed two Annual Service Reviews, in 2008 and in 2009. An annual service review is where we look at all the information we have gathered about a service in the last year, including the managers Annual Quality Assurance Audit and surveys that we send to people who live in the home. From this we make a judgement about whether the home is continuing to provide a good service to people, or whether we need to inspect sooner than planned. We received positive feedback on Risedale at each annual service review, and did not alter our inspection plan. Copies of all these reports are available on request from us, or from the care home. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? Care Homes for Older People Page 8 of 30 Since the last inspection there has been ongoing redecoration and general refurbishment work at Risedale. All corridors and communal rooms had been fully decorated and had new flooring and curtains provided. There was new dining room furniture and new televisions in the lounges. An additional en suite bedroom had been provided on the Ivy unit. There was a new fire alarm and nurse call system in place. The home had implemented the NHS Gold Standard Framework for end of life care and the Dignity Challenge. Staff had received training on this, and other training had continued with some other new subjects such as Mental Capacity Act and Deprivation of Liberty Safeguards being added. Training materials in all subjects were routinely updated to ensure staff were taught current best practice. The home had increased the number of care staff with a National Vocational Qualification (NVQ) in care to 84 . Through consultation with people the menus had been altered and there were plans to resurface the car park, and to refurbish the Ivy unit. 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 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 30 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 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission procedures help people to be well informed about the care home, and gives them confidence in knowing their assessed needs will be met. New people are made welcome and helped to settle in quickly. Evidence: The service had good arrangements in place for admitting new people and helping them to settle in. There was good written information about the care home that described the type of care, services and facilities offered. People were able to visit to look around the home and ask questions. New people were only offered a place in the home once a full assessment of their personal, health and social care needs had been completed, and showed the home would be suitable for them. We looked at the admission assessments of two people quite new to the service and found these were fully complete and very detailed. These assessments were completed by senior staff who visited and spent time with the Care Homes for Older People Page 11 of 30 Evidence: person. Information was also gathered from other professionals involved in the persons care such as hospital staff, district nurses and social workers. A copy of the completed assessment was sent to the person and their family along with a letter stating whether the home could meet their needs, or if not explaining why. The admission process worked well and enabled staff to be fully prepared for new people arriving. The staff team would already know about the person and have their bedroom and any necessary equipment ready for them. People were allocated a carer to be their key worker, to take a special interest in their care. People we spoke with told us the staff were very friendly and had helped them settle into the home quickly. Staff said they paid extra attention to new people to ensure they felt comfortable and safe. People who responded to our survey told us they had been given enough information to help them decide if this was the right home for them, and confirmed they had been issued with the terms and conditions (contract) for their stay. The service no longer provides intermediate care. The intermediate care/ rehabilitation unit re-located to a new Risedale Estates Ltd home in 2008. Care Homes for Older People Page 12 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were receiving very good quality personal and health care that was beneficial to their general well being, and that was delivered in the way they wanted. Evidence: The home provides personal care for older people and people with physical disabilities. They also provide care for people with dementia within the Ivy Unit which is separate from the rest of the home. We spoke with, and looked at the care planning and care delivery for people living in both parts of the home. Each person had an individual plan of care which had been reviewed monthly and updated as necessary to reflect any changes in the persons care needs. The care plans were specifically tailored to each individual and contained information about their personal wishes and choices. Records showed that people received the health care they needed, and were able to access their doctor, the district nurse, chiropodist, dentist, dietitian, and other specialist staff such as the continence and mental health nurse. Care Homes for Older People Page 13 of 30 Evidence: We spoke with one of the visiting district nurses who confirmed that the Risedale staff worked well with her, listened to and followed her advice, saying the staff were prompt in asking for her input if they were concerned about someone. Staff had been trained in measuring peoples blood pressure and monitored some people regularly as requested by their doctor. Peoples weight was also monitored, and action was taken where unwanted weight loss occurred. People we spoke with said they were very happy in the home, and were treated with dignity and respect. They told us; The carers are marvellous The carers are very good, everything is fine, we are quite happy here Everyone gets bathed regularly and clothes and bedding are changed frequently ... the staff dont make any fuss if there is a mess, and they make you feel at ease. In our surveys people confirmed that they always got the care and support they needed, and people wrote; They provide good care They look after every one as individuals. They take good care of people We found the staff were very knowledgeable about the people living in the home, and understood their care needs well. We saw that staff were vigilant to changes in peoples condition and pro-active in making referrals for external health care advice as necessary. On the day of our inspection staff had reason to believe one person was beginning with an infection and were taking action on this. Another person had been supplied a new and unexpected medicine, and staff were checking this with the doctor to ensure a mistake had not been made. It was clear that staff thought about the care they delivered rather than automatically completing tasks. We looked at the management of medicines in all areas of the home. All staff who handled medicines had been suitably trained in this and had their competency reassessed every year. We found that medicines records and storage were in good order and again staff were able to demonstrate good knowledge of peoples needs. We saw that medicines due at odd intervals such as on alternate days or once a week were Care Homes for Older People Page 14 of 30 Evidence: well managed. Blood thinning medicines that are given in relation to blood test results were being carefully managed. There were arrangements in place for people to manage their own medicines if they wished to, within a risk assessment framework. The home had introduced the NHS Gold Standard Framework for end of life care and had implemented the Dignity Challenge. Staff had received training on this and had access to specialist staff within the Risedale group for support as needed. We saw that end of life care had been discussed with people where appropriate, and their views and wishes recorded and taken into consideration. Care Homes for Older People Page 15 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were enabled to lead a fulfilling lifestyle of their choice and had access to a good variety of activities and entertainment. People were consulted about the provision of meals and enjoyed a varied and nutritious diet. Evidence: People were able to move freely around the home and spend time in their bedrooms or in the lounges as they chose. We saw that a number of people enjoyed a walk outside, saying they did so every day. The Ivy dementia care unit had open access to a secure garden area so people could safely go and spend time outdoors. Some people told us they liked to stay in their bedrooms and entertain themselves with their hobbies, whilst others like to gather in social groups in the various lounges around the home. There were two activity organisers, one for each unit in the home, and we saw a number of activities taking place throughout the day. On the residential unit people organised themselves a game of dominoes which they said was a regular event. The activity organiser helped people use interactive computer games for gentle enjoyable exercise. Other regular events included crafts, slide shows, foot spas and massage. On the Ivy unit we saw people engaging in a reminiscence session using pictures and Care Homes for Older People Page 16 of 30 Evidence: objects relating to past events and this prompted a lively sharing of memories. Later there were games with soft balls and skittles. The activity organisers told us they had attended training in chair aerobics and music therapy, and were due to attend some cognitive therapy training. They also completed dementia awareness, and health and safety training. The activity organisers linked together to organise outside entertainers coming into the home and people living in both units were invited to these events. We also heard how one person living on the Ivy unit regularly joined in with residential unit activities that staff knew they liked. There were visiting clergy and two churches in walking distance of the home. Information about peoples interests and hobbies was recorded in their care plan and staff used this to help them plan the activities and events. There was a small library provided and the books were changed periodically by the visiting library service. People who completed our surveys told us the home always or usually provided suitable activities for them. People we spoke with said; There is always something going on if you want to join in, and there is no pressure to do it if you dont want to We have plenty of things to do and I like to go out for walks A number of people told us they went out with their family on shopping trips or for meals out. Visitors were made welcome and said they were offered refreshments. Many people had their own telephone in their bedroom, and there was a pay phone in a cubicle where people could make calls in private. We asked people about the meals provided and received mainly positive feedback. People said; The food could better The meals are lovely, there is a good choice I enjoy the meals here Some days its not so good, and I tell them... breakfast and tea are the best We have very good cooks Care Homes for Older People Page 17 of 30 Evidence: There was a choice of two main dishes at lunch and tea time, with people being asked their preference the day before. We saw lunch being served in the four dining areas and saw staff were available to assist people if needed, and there were drinks and condiments available. We saw that lunch was a social occasion and people we spoke with said they had enjoyed their meal. Staff monitored how well people ate and people were weighed regularly to ensure they maintained a healthy weight. There were regular residents meetings and we were able to listen in to a meeting that took place during the inspection. The cook and activity organiser attended and were able to answer peoples questions and listen to their suggestions. Everyone had an opportunity to speak up if they had any comment to make and we saw from the minutes of the last meeting that peoples ideas had been acted on. Care Homes for Older People Page 18 of 30 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 excellent 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 said they felt safe and were listened to. They were confident they could raise any concerns or complaints with the manager or staff, and they would be promptly addressed. Evidence: The home had a complaints procedure which was on display and every one living in the home had been provided with their own copy. People who responded to our surveys confirmed they knew how to make a complaint and had someone they could talk to if they were worried. People we spoke with said they could report any concern to the manager or staff and felt confident the matter would be sorted out. They also said they could raise any issue at the residents meetings. The manager had not received any complaints in the last year, and none had been made directly to the Care Quality Commission. There were policies and procedures to guide staff on safeguarding issues. All staff had received training on recognising and reporting abuse and understood their responsibility to keep people safe. Staff had also attended training on the Mental Capacity Act and Deprivation of Liberty Safeguards. This training was updated annually. There had been no safeguarding referrals made in the last year. The service has in the past managed concerns, complaints and protection issues well. The manager and registered provider work well with the commission and with the local Care Homes for Older People Page 19 of 30 Evidence: authority, and have been pro-active in making safeguarding referrals when they have been concerned for a persons welfare. Where there have been concerns or complaints, these have been fully investigated and any shortfalls have been put right very quickly. Care Homes for Older People Page 20 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable, clean and well maintained home that has suitable aids and adaptations to enable people to lead an independent life. Evidence: Risedale is a purpose built care home that is decorated and maintained to a high standard. Since the last inspection all communal rooms and corridors have been decorated and had new flooring and new curtains provided. There was new dining room furniture and new televisions, including one with a very large screen for film events and interactive computer games. Every bedroom in the residential unit has a full en suite bathroom. These either have a bath with a a seat and shower attachment, or a wet room shower facility. There are toilets situated close to the day rooms, and a hairdressing salon. There are two dining rooms and two lounges, plus a large seating area in the reception. There are smaller sitting areas in the wide corridors where people like to congregate. The Ivy dementia care unit is secured by keypad access. It also has two lounges and two dining rooms. Some bedrooms have en suite facilities and there are two bathrooms with new baths and a separate shower room. A new additional en suite bedroom had been provided. There are toilets located close to the day rooms. There is access outside to a secure garden area. The home has a five year development plan Care Homes for Older People Page 21 of 30 Evidence: which details planned refurbishment work and equipment purchases. The driveway was about to be resurfaced at the request of people living in the home, and there were plans to to more refurbishment in the Ivy unit. There was a new fire alarm and nurse call system installed. There are plenty of aids and adaptations around the home to help people with mobility problems, including hand rails, and hoists. There are electric profiling beds and pressure reducing mattresses for those people assessed as needing them. People had been able to bring their own furniture and other possessions into the home and had made their rooms individual and homely. Bedrooms doors had locks fitted and some people chose to keep the key and lock their rooms when they left them. The laundry was well organised and operated a one way system. This means dirty laundry comes in through one door, progresses through the washing, drying and ironing areas and leaves through a separate door. This is good infection control practice. There was a new rotary iron. All staff receive mandatory annual training in infection control and there are good hand washing facilities including soap dispensers, paper towels and hand gels. People told us they were satisfied with the laundry saying; My clothes are taken and come back the next day nicely ironed and all on hangers ... the bedding and towels are regularly changed. One person told us They could improve the laundry, and we understand this was due to items of clothing going missing. Laundry staff did have facilities to name mark clothing and frequently asked people to look and and claim unmarked items. The home was clean and fresh throughout and people told it was always this way, saying; The cleanliness is very good They keep the home clean They are in here every day cleaning my bathroom and toilet, its spotless. Care Homes for Older People Page 22 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a highly trained, skilled and caring staff team, who have time to engage with them. Evidence: The home was sufficiently staffed to meet peoples care needs and enable staff to spend time engaging with people. We observed a relaxed and friendly atmosphere throughout the day. The staff structure consists of seniors, team leaders and care assistants. Rotas showed that there was a good skill mix across the shifts and a Risedale manager was on call at all times should staff need additional support or advice. There were four care staff working on the residential unit, and four on the smaller dementia care unit. They were being managed and supported by a senior carer while the home manager was on leave. There was also a receptionist, a maintenance man, a laundry assistant, four domestics, a cook, two kitchen assistants and two activity organisers on duty. Staff training was given a high priority with all new care staff completing a comprehensive two week induction training in the Risedale Training department. Following this there were compulsory annual updates in moving and handling, fire safety, infection control, safeguarding and medicines administration. Staff also Care Homes for Older People Page 23 of 30 Evidence: received training in challenging behaviour, dementia care, food hygiene, end of life care and first aid. Risedale support care staff to undertake National Vocational Qualifications (NVQ) in care, and 84 of the staff team had achieved this at level 2 or above, which is excellent. Kitchen and domestic staff were supported to achieve an NVQ suitable to their role. We looked at staff recruitment procedures and found these were very thorough. All new staff were subject to interviews, written references and criminal records checks, to ensure they were suitable for working with vulnerable people. We talked with, and received completed surveys, from the staff group, who gave very positive feedback about their work at Risedale. They told us the following; I enjoy my training and have completed an NVQ in care ... I have good work colleagues ... the home has a good work atmosphere ... its enjoyable to come to work. I feel the home meets residents needs very well ... the food is excellent with a wide choice ... it is a clean, homely, happy place with excellent care given. I have been at Risedale for a number of years and it gives an excellent service to the residents in a safe and secure atmosphere and has a manager whose door is always open to residents, staff and families. It is always a pleasure to work at Risedale the training is of a high standard. The home provides a safe happy environment for people to live in, and their health and well being is paramount at all times. All staff are highly trained. All training is excellent, all manager and directors are approachable, clients needs always addressed promptly. People we spoke with gave very positive feedback about the staff team, saying, The staff are great They are all wonderful. The people who completed our surveys said that staff were always or usually Care Homes for Older People Page 24 of 30 Evidence: available when they needed them, and always listened to them. Care Homes for Older People Page 25 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe and well managed home, where they are consulted and their views are listened to and acted on. Evidence: The registered manager Mrs Pam Harper has been in post for many years and is suitably qualified and competent to manage the service. She has completed the Registered Managers Award and has a Diploma in Management. She is supported within the home by senior carers and team leaders. She is also supported by the Risedale directors. The company operated a comprehensive quality assurance system which included out of hours visits by the manager and directors, surveys and audits. There were regular residents meetings where people were able to put forward their suggestions and provide feedback on the quality of the service. The manager also sent out quality surveys periodically to gain peoples views about they way home was being run. As a result of consulting with, and listening to people, changes had been made to the Care Homes for Older People Page 26 of 30 Evidence: menus, the car park was to be re-surfaced, and some refurbishment is to take place in the Ivy unit. We saw that monthly audits were carried out by the manager and senior staff to check that care plans were fully complete and updated. Other audits included kitchen hygiene, the general environment, safety of equipment, and accident reports. This is good practice and helps to ensure that high standards are maintained in all areas of the service. There was a five year development plan in place for the service detailing planned refurbishment and renewal of equipment. There was clear evidence of strategic planning, and ongoing investment and improvement in the service. The manager holds spending money on behalf of some people and we looked at the way this was managed. The individual records, receipts and monies were held securely, and audited regularly. There was formal staff supervision in place, with staff having five individual supervision sessions per year with their allocated senior, and one annual appraisal. Staff told us; Staff and residents are extremely happy to be here, management are extremely considerate toward staff and always have a listening ear. If I have any suggestions for improvement I can talk them over with the manager as she is very approachable and open minded to suggestions. Risedale employ a health and safety manager who delivers staff training and meets regularly with the maintenance team to ensure the health and safety of residents and staff is protected. We saw some service records for the home which showed fire safety and other equipment underwent regular safety checks and inspections. Health and safety training for staff was robust and took place at frequent intervals including fire safety, moving and handling, infection control, food hygiene and management of challenging behaviour. All shift leaders were qualified 1st aiders. The kitchen had been awarded an excellent food safety rating by the environmental health officer. We judged the health, safety and welfare of residents and staff was being sufficiently promoted and protected. Care Homes for Older People Page 27 of 30 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 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 29 of 30 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. Care Homes for Older People Page 30 of 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!