Care Home: Rivacre Rest Home

What the care home does well There is little change in the people who live and work at Rivacre since our last visit, which helps build up relationships with people who live at the home. One person who lives at the home spoken to said, "We have got to know each other well". The owner spoken to said, "We are aware of what each person needs because we have been together for a long time". Daily routines in the home appeared relaxed with people allowed unrestricted access to communal areas and free to come and go as they please. One person who lives at the home said, "I please myself if I want to go out or stay in as long as I let them know". The owners of Rivacre live on the premises and have over 25 years experience of supporting people who have mental health issues and are qualified to provide the care and support people need to ensure they are looked after and able to live an independent life as possible. One person who lives at the home spoken to about the staff and the owners said, "They are always there to help". another said, "They are available 24 hours a day". What has improved since the last inspection? Walking around the building we found improvements made to the decoration and furnishings of the home, so that people can live and work in pleasant surroundings. One person who lives at the home spoken to said, "They have done up the bathroom nice". The owner spoken to said, "We keep on improving the decoration". The owner confirmed the improvements in the AQAA by telling us of the new bathroom installed and redecoration of bedrooms. A new fire risk assessment has been introduced at the home and the owners are familiar with the procedures to ensure people who live at the home are safe and protected. What the care home could do better: The owners should make available an up to date Service User Guide (brochure) setting out the aims, objectives, facilities available and special needs of people they can cater for, ensuring people have the information to make an informed choice. The plan of care for each individual who live at the home should be reviewed once a month by care staff and updated to reflect any changes. We spoke to the owner who said, "We are completing reviews for all residents this month". Care records for each person who live at the home should have recorded nutrition, weight loss or gain kept periodically and appropriate action taken if any problems are identified. For the safety of people who live in the home, windows in bedrooms above the ground floor should be restricted from opening fully to minimize the risk of falling out. Key inspection report Care homes for older people Name: Address: Rivacre Rest Home 3/5 Grasmere Road Blackpool Lancashire FY1 5HS     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: Kevan Royston     Date: 0 9 0 9 2 0 0 9 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 26 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) 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Rivacre Rest Home 3/5 Grasmere Road Blackpool Lancashire FY1 5HS 01253621103 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Ramendu Chanda,Mrs Shreemuttee S Chanda care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: 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: Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 11 Date of last inspection Brief description of the care home Rivacre is a residential home for older people who are mentally ill. The home consists of single and double rooms. There are sufficient toilet and bathroom facilities available for all residents, aids and adaptations are provided if required. There is a stair lift to provide access to the first floor. The home is situated near the centre of Blackpool close to the main shopping area and local bus routes. The property is a terrace house with seating provided in the front garden. There are call bell systems provided in all rooms. There is a large through lounge with a separate kitchen and dinning area provided for the residents. There is a statement of Purpose/Service user Guide, which is given to all prospective residents. This written information explains the care service Care Homes for Older People Page 4 of 26 11 Over 65 0 Brief description of the care home that is offered, who the owners and staff are and what the resident can expect if he or she decides to live at the home. The fees at the home are £293.91 per week. Charges for hairdressing and chiropody vary. Care Homes for Older People Page 5 of 26 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: This unannounced visit was part of the key inspection process and took place on the 09/09/09. We spoke to people who live at the home, The owners and a group of residents in the lounge. Care, maintenance, previous inspection reports and other records were looked at, as well as a walk around the building. As part of the inspection process we talked to people using the service and asked the owners about those people needs. We also looked at their rooms, care plans and daily notes, this is called case tracking. Other people who live at the home were invited to pass their opinions to us if they wish. We sent out surveys/ questionnaires to people who live and work at Rivacre for their views on how the home is run. Unfortunately due to there being only 5 residents and one part time member of staff we had no responses, however from speaking to residents we received positive comments and some are included in this report. Care Homes for Older People Page 6 of 26 Every year the person in charge or manager is asked to provide us with written information about the quality of their service they provide and to make an assessment of the quality of their service. This document is called an Annual Quality Assurance Assessment (AQAA). We use this information, in part, to focus our inspection activity. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 26 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 26 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 26 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. The admission and assessment procedures were clear and precise, to ensure care needs of people who live at the home can be met. Evidence: We looked at the admission procedure and case tracked a person who lives at Rivacre. Comprehensive information was obtained by the owners and from social services in relation to health, welfare, mental health and personal details to ensure the care and support could be provided and a plan of care developed. We spoke to a person who lives at the home about the time he moved in and he said, Its been good from the start. A care plan had been developed from the assessment information to ensure health, social and welfare needs are identified and the care and support needed can be met. There was evidence of family involvement to gather information so that all needs of people who come to live at the home are looked at. We spoke to one of the owners who said, We like people to visit first a few times Care Homes for Older People Page 11 of 26 Evidence: The owner of the home informs us in the AQAA how the process for assessing people is undertaken prior to them moving in and a plan of care developed with input from social workers and community psychiatric nurses (CPN), as well as their own assessment to ensure a thorough process has been completed before people move into Rivacre. We looked at the Service User Guide (brochure) which is available for potential residents and families setting out what the home provides, the terms and conditions and the aims and objectives. However this should be updated to include all the information about the home and the people they can provide professional care and support for, to ensure they meet the needs of the individual and people can make an informed choice. Standard 6 was not assessed as the home does not provide intermediate care. Care Homes for Older People Page 12 of 26 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. People who live at the home have their health and personal care needs met by staff who respect their privacy and dignity. Evidence: Care records looked at for people living in the home were comprehensive and set out a plan of care monitoring all health,welfare, mental health and social needs. Relatives and people who live at the home have a say in care plans and in the way they are supported. This was evidenced by signatures of care records by the resident, and recorded meetings with people who live at the home. We spoke to the owner who said about the care of people who live at the home, We have had our residents for a number of years and being a small family run home with one part time staff, we know each resident well and what there needs are. Although care plans are in place they are not all being reviewed once a month. Care plans should reviewed monthly to ensure the care and support is continuously monitored and any changes are recorded and appropriate action taken. Each person has a risk assessment in place to ensure their safety and reflect any changes that may have occurred in the building or individually ensuring people are protected and safe. Care Homes for Older People Page 13 of 26 Evidence: We went through the medication procedures with the owner, medication of the person we case tracked had safe practices in place ensuring people receive the right medicine at the right time and they are protected by the procedures in place. The owner said, The part time member of staff and ourselves give out medicines as we have had the training. During our time at Rivacre we talked to people who live here in the lounge and watched how the owners who run the home caring for people and helping them in a sensitive, dignified way. One person who lives at the home said to us, They are very kind and treat me with respect. The owner tells us in the AQAA how it is important for staff to care for residents with respect, dignity and equality. Care records looked at show nutritional screening of people who live at the home is not always checked and monitored, This should be done every so often so that any problems can be identified and acted upon. Notes of people who live at Rivacre show they have access to health professionals and where possible a doctor (GP) of their choice. Care Homes for Older People Page 14 of 26 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. Social activities and meals are well managed, creative and provide daily variation and interest for people living at the home. Evidence: Routines watched during the day looked relaxed, some people were sat in the lounge area, two were getting ready to go out, when spoken to one said, We enjoy a little walk out. There is only five residents so social activities and trips out are centred around individuals needs. One person who lives at the home spoken to said, I enjoy going out with friends and family to watch the football. The owners tells us in the AQAA how activities are flexible to suit each person to ensure they are supported to follow their interests. One of the owners spoken to said, Two residents enjoy going to church, another enjoys the local library. We had a look around the kitchen area and saw one of the owners preparing lunch with fresh produce being used, to ensure people who live here receive a healthy diet with plenty of choice. A person who lives at the home spoken to about meals and set times said, Meal times are to suit us. Another said about the quality of food, The food is very nice. At the time of the visit they were making home baked cakes for the people who live at the home to ensure they enjoy some home cooking. Care Homes for Older People Page 15 of 26 Evidence: We spoke to people who live at the home about visiting times and if any restrictions had been placed upon people calling to see them. Residents spoken to confirmed friends and relatives are welcome any time, one person who lives at the home spoken to said, Visitors come and go as they please. The owner confirms in the AQAA visitors are welcome any time, there is a visitors policy explaining people are welcome to see friends and relatives when they wish to. People we spoke to who live here confirmed they were able to bring some personal items into the home, one person who lives at Rivacre spoken to said, I brought my guitar with me Rooms we were invited into had personal possessions around so that people who live here felt it was home. Care Homes for Older People Page 16 of 26 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. Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. Evidence: The owner tells us in the AQAA how every person who comes to live and work at Rivacre are provided with a copy of the complaints procedure to ensure they are aware of the way to complain if they have any problems. Also there is a policy available in the home for visitors to see. One person who lives at the home spoken to about the procedure to make a complaint said, Dont worry I know what to do. There has been no complaints since the last inspection. The owner told us she has recently completed some safeguarding adults training and this was confirmed by information provided in the AQAA. The owner also said the part time member of staff has completed safeguarding training at her other place of work. Care Homes for Older People Page 17 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises is clean and maintained to a good standard providing comfortable surroundings for people who live at Rivacre. Evidence: We had a walk around the building with one of the owners, the building was clean, free of offensive odours and tidy. We spoke to a person who lives at the home about the environment and he said, Its kept clean. From looking around the home and information in the AQAA we can confirm they continue to improve and update the home in terms of redecoration and new furnishings. One bedroom had been completely redecorated with a new carpet fitted, also the bathroom had new fittings installed and repainted, to ensure people who live at the home have pleasant surroundings. One person spoken to said, We have improved the decoration.We found in some bedrooms, windows did not have restricted openings to keep people safe. Windows should be restricted from opening fully to ensure residents are kept safe and minimize the risk of falling out. There is a record of maintenance kept and and any minor repairs are completed by the owners. They have access to contractors should they need to have anything major fixed. One person who lives at the home spoken to said, My door was fixed straight away. Care Homes for Older People Page 18 of 26 Evidence: They have procedures in place for laundry processes and infection control policies, ensuring the home is kept clean and hygienic. Care Homes for Older People Page 19 of 26 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. Access to training and staff development is good. Recruitment procedures are in place if any staff are to be employed. Evidence: No new staff have been recruited for a number of years. The small staff team have worked at Rivacre together for over nine years and the home is run as a large family home. One staff member has received training and completed a National Vocational Qualification (NVQ) to level 2, ensuring she has the competencies, experience and skills to provide the care for people who live at the home. One of the owners spoken to said, We go on any training that may help improve our knowledge and help the residents. One person who lives at the home when spoken to about the staff said, They are helpful and willing to listen. We can confirm from information provided in the AQAA and previous inspection reports the part time staff member has received up to date training in dementia care, mental health and health and safety procedures. The owner said, She is always attending training through her other part time job. Copies of qualifications and courses attended were available to look at. No new staff have been employed at the home for a number of years, however the owners assured us the proper checks would be in place prior to any member of staff starting work at the home. Information in the AQAA confirms the owners are aware of the recruitment procedure and have robust systems in place to ensure suitable people Care Homes for Older People Page 20 of 26 Evidence: are employed. Care Homes for Older People Page 21 of 26 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 well and has policies and procedures in place to ensure the health and safety of staff and people living at Rivacre are promoted and protected. Evidence: Although this is a small home the owners have systems in place to get people who live at the home and families views on how Rivacre is run. A suggestion box is situated at the front entrance of the building for people to put forward any ideas to improve the running of the home. Any suggestions made and agreed are put into place to ensure Rivacre improves for the people who live here. One of the owners informed us this is done mainly in an informal way at meal times when everybody eats together. One person who lives at the home spoken to said, They always ask about how we can do things better and if there is anything we need. Both owners who runs the home are qualified mental health nurses and have a wealth of experience in running care homes. One of the owners spoken to said, I have worked in mental health for over 25 years and completed my Management Care Homes for Older People Page 22 of 26 Evidence: qualification. We spoke to people who live at the home about the owners and staff, one said, They are both gentle and kind. We checked records of health and safety and confirm regular tests are carried out to emergency lighting, fire procedures, gas appliances and electrical equipment, ensuring the safety of people living at the home is maintained. Information contained in the AQAA confirmed these tests have been completed when they should be. We looked at financial records and found good systems in place for people to control their own money where possible and ensure safeguards are in place for their protection. Records of finances for people who live at the home were accurate and up to date. Care Homes for Older People Page 23 of 26 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 26 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 1 1 The owner should make available an up to date Service User Guide (brochure) setting out the aims, objectives, facilities available and special needs of people they can cater for ensuring people have the information to make an informed choice. The plan of care for each individual who lives at the home should be reviewed once a month by care staff and updated to reflect any changes. A record of nutrition, weight loss or gain should be kept periodically for each resident and appropriate action taken if any problems are noticed. For the safety of people who live in the home, windows should be restricted from opening fully to minimize the risk of falling out. 2 7 3 8 4 19 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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