Care Home: Riverside Care Centre

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What the care home does well Riverside Care Centre provides the people who use the service with a wellmaintained, safe and homely environment to live in. The staff team work hard to meet the residents` needs in a manner that treats them with respect and dignity. Where ever possible residents are fully supported by the staff team to make decisions about their own lives. There is a strong commitment to helping residents maintain their social and family contacts and relatives were seen visiting at different times throughout the day. Staff practices and care plans examined promoted individual human rights and choice with fairness, equality, dignity and respect, and these are central to the care provided. Residents seen were comfortable, well dressed, clean and nourished. A relative who volunteered information about the standard of care at the home told the inspector, `this home is really clean, no smells, very welcoming and really homely. There are different rooms to walk around, staff are wonderful and supportive to relatives, right down to the cooks and they all take an interest in the residents. There is a big difference in the home since the last owners, staff work really hard, absolutely marvellous. I`m really more than happy having my mother here`. Good dementia practice was observed when care staff were seen spending time talking, holding hands, laughing with and listening to residents over a cup of tea. Ensuring residents emotional, social and psychological needs were met throughout the day. A resident who lives at the home told us. `The care and love I get here has helped my rehabilitation enormously. I have spent some of the happiest years of my life here. The food at Riverside is home cooked and enjoyable, I have a full life here at Riverside, I am happy and content and would recommend Riverside Care Centre to anyone.` 82% of the staff team are trained to NVQ level 2 or above in Care What has improved since the last inspection? The registered manager was able to discuss and demonstrate her understanding of the key principles and focus of the service. She and her team have carried out some much-needed work around the systems and policies and procedures so that there are better overall outcomes for the people who use the service. Existing service policies and procedures have also been reviewed and updated to meet the National Minimum Standards, current thinking and practice and underpin good practice. It is apparent that the residents` quality of life is paramount to the staff team and the newly reviewed care plans support this by focusing on the delivery of care being responsive and person centred promoting their human rights which means the needs of the residents are better met. The manager ensures that residents are involved in risk assessments and these are taken into account in planning the care and routines of the home. A majority of record keeping and management systems at the home have improved to ensure safe working practices and the efficient running of the service. Records of residents` monies are in place to safeguard and protect the financial interests of the people who use the service. Medication policies and procedures about safe storage of topical creams must be followed to ensure the resident`s medication has the desired effect. Opportunities for residents` activities have increased due to the recruitment of an activity co-ordinator. This means that the quality of life of the people who use the service might be improved. 78% of the care staff have received dementia awareness training and 60% of the care staff are now trained in Safeguarding and the protection of vulnerable adults. This means that more of the care staff have the relevant skills, knowledge and competence to carry out the duties that are expected of them and are able to meet the residents needs. Improvements have been made in the way the service measures the quality of care in the home. Surveys are completed annually and include the views of relatives and where possible residents to ensure the home is run in the best interest of the people who use the service What the care home could do better: The lack of continual staff supervision, monitoring and written records to verify discussions between care staff and managers means that some areas of care practice and staff development might be unmet and unrecognised. This means that care staff might feel unsupported and not carry out their duties to the best of their abilities and residents` needs might not be fully met. CARE HOMES FOR OLDER PEOPLE Riverside Care Centre Sawley Clitheroe Lancashire BB7 4LF Lead Inspector Mrs Christine Mulcahy Unannounced Inspection 10:30 18th August X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Riverside Care Centre Address Sawley Clitheroe Lancashire BB7 4LF Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01200 441205 01200 440130 Canterbury Leased Homes Limited Mrs Gail Linda Ainsworth Care Home 40 Category(ies) of Dementia (38), Old age, not falling within any registration, with number other category (2) of places Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 40 service users to include: *Up to 38 service users in the category of DE (Dementia). *Up to 2 service users in the category of OP (Old age not falling within any other category). When the named service users in the category of OP leave the home, the registered person shall apply in writing to make all places DE. 30th April 2007 2. Date of last inspection Brief Description of the Service: Riverside Care Centre is registered with the Commission for Social Care Inspection to provide care and accommodation for up to 38 older people who have dementia and two people without dementia. The home is situated in the Village of Sawley near Clitheroe in Lancashire’s Ribble Valley. It is a detached property set in its own grounds and is made up of a one level purpose built unit and a 3 storey Victorian house. Both units give the people who use the service good access to all facilities in the home. The old house provides accommodation on two floors access to the first floor is via a stair lift. All bedrooms are single occupancy; some are en suite and are situated on the ground floor of the home. They are all homely and fully furnished with a complementary basket of toiletries for new residents. There are several lounges and communal areas throughout the home and both units provide the resident’s with the opportunity to mix socially or enjoy their privacy. There is a secure courtyard that provides a safe environment for the residents to enjoy a game of bowls or skittles or just to relax in the fresh air. Parking is to the front of the building and residents can enjoy a spot of gardening in the extensive gardens surrounding the home. A village hall and public house are nearby and there is a return bus service that provides transport to Clitheroe every hour. Residents and their relatives receive a copy of the Service User Guide and the Statement of Purpose. Fees range from £346.00 - £550.00 per week depending on residents assessed needs. Residents are billed separately for hairdressing, newspapers, magazines, toiletries, private dental and chiropody care, aromatherapy and nighttime incontinence pads. Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection included a visit to the home and took place on 18th, 19th and 20th of August 2008. Information was obtained from residents care plans, staff records, policies and procedures, management systems and inspector observations, 4 relative/ carers surveys and 8 staff surveys. The inspector also spoke to 15 of the people who live at the home, 1 relative, 4 care workers and the registered manager. Since the last inspection there have been 2 complaints about the increase in residents fees. The management team has addressed both complaints with satisfactory outcomes for the complainants. Because people with dementia are not always able to tell us about their experiences, we have used a formal way to observe people in this inspection to help us understand. We call this a Short Observational Framework for Inspection (SOFI). This involved us observing up to five people who use the services for two hours and recording their experiences at regular intervals. This included their state of well being, and how they interact with staff members, other people who use the services, and the environment. The quality rating for this service is 2 Star. This means the people who use this service experience good quality outcomes. What the service does well: Riverside Care Centre provides the people who use the service with a wellmaintained, safe and homely environment to live in. The staff team work hard to meet the residents’ needs in a manner that treats them with respect and dignity. Where ever possible residents are fully supported by the staff team to make decisions about their own lives. There is a strong commitment to helping residents maintain their social and family contacts and relatives were seen visiting at different times throughout the day. Staff practices and care plans examined promoted individual human rights and choice with fairness, equality, dignity and respect, and these are central to the care provided. Residents seen were comfortable, well dressed, clean and nourished. Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 6 A relative who volunteered information about the standard of care at the home told the inspector, ‘this home is really clean, no smells, very welcoming and really homely. There are different rooms to walk around, staff are wonderful and supportive to relatives, right down to the cooks and they all take an interest in the residents. There is a big difference in the home since the last owners, staff work really hard, absolutely marvellous. I’m really more than happy having my mother here’. Good dementia practice was observed when care staff were seen spending time talking, holding hands, laughing with and listening to residents over a cup of tea. Ensuring residents emotional, social and psychological needs were met throughout the day. A resident who lives at the home told us. ‘The care and love I get here has helped my rehabilitation enormously. I have spent some of the happiest years of my life here. The food at Riverside is home cooked and enjoyable, I have a full life here at Riverside, I am happy and content and would recommend Riverside Care Centre to anyone.’ 82 of the staff team are trained to NVQ level 2 or above in Care What has improved since the last inspection? The registered manager was able to discuss and demonstrate her understanding of the key principles and focus of the service. She and her team have carried out some much-needed work around the systems and policies and procedures so that there are better overall outcomes for the people who use the service. Existing service policies and procedures have also been reviewed and updated to meet the National Minimum Standards, current thinking and practice and underpin good practice. It is apparent that the residents’ quality of life is paramount to the staff team and the newly reviewed care plans support this by focusing on the delivery of care being responsive and person centred promoting their human rights which means the needs of the residents are better met. The manager ensures that residents are involved in risk assessments and these are taken into account in planning the care and routines of the home. A majority of record keeping and management systems at the home have improved to ensure safe working practices and the efficient running of the service. Records of residents’ monies are in place to safeguard and protect the financial interests of the people who use the service. Medication policies and procedures about safe storage of topical creams must be followed to ensure the resident’s medication has the desired effect. Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 7 Opportunities for residents’ activities have increased due to the recruitment of an activity co-ordinator. This means that the quality of life of the people who use the service might be improved. 78 of the care staff have received dementia awareness training and 60 of the care staff are now trained in Safeguarding and the protection of vulnerable adults. This means that more of the care staff have the relevant skills, knowledge and competence to carry out the duties that are expected of them and are able to meet the residents needs. Improvements have been made in the way the service measures the quality of care in the home. Surveys are completed annually and include the views of relatives and where possible residents to ensure the home is run in the best interest of the people who use the service What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP 1, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service were given clear information about the home and a comprehensive needs assessment was done before they moved in so they knew their individual needs would be met. EVIDENCE: The Statement of Purpose and Service User Guide are clearly written to help people understand what services the home can provide. Both documents clearly set out the objectives and philosophy of the service and the specialist dementia service it offers. The Statement of Purpose contains a letter from a resident detailing her views about the home and a copy of a compliment note from relative telling us, ‘We would like to thank each and every one of you for the outstanding care our relative received at Riverside. I’m so glad our instincts were right when we came to look around. We can’t thank you enough for everything you’ve done for her and us her family”. Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 10 Residents on admission to the home receive a copy of the Service User Guide as part of a welcome pack. The pack includes a description about the function of the service like catering and laundry services, the service aims and objectives, staff structure, privacy, maintenance, activities, and a summary of the service complaints procedure. New residents are also given decorative notelets with written details of their new address so they can inform relatives and friends who want to keep in touch with them. The manager said that admission to the home only takes place if they are confident they have the skills, ability and qualifications to meet the prospective residents assessed needs. The care plan of one resident was examined and showed that a comprehensive needs and risk assessment was carried out before admission into the home. The resident had been provided with clear and easy to read contract. The assessment documentation was always available to staff which helped familiarise them with the residents needs. Intermediate care is not provided at this service. Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and social care needs of the people who use the service were clearly set out in a plan of care. Residents were protected by the homes medicine policies and procedures. The care practices observed showed residents privacy and dignity was fully respected. EVIDENCE: Case tracking of 3 people who used the service, examination of residents’ personal files and discussion with the manager confirmed that all resident’s had a comprehensive plan of care that included sufficient detail for staff to meet the identified needs. Each plan had been reviewed regularly and included initial information like name and address and emergency contact details. The care plan also included details about residents daily living pattern including written information about their personal care and physical wellbeing. Where necessary moving and handling assessments and risk assessments clearly described the action to be taken and the risk associated with the activity. Care plans had been reviewed regularly and changes in the resident’s needs were identified and acted on immediately. Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 12 All of the residents’ care plans and associated records have been fully reviewed and those seen focused on individual needs and maintaining a level of care that was responsive and person centred. Other records examined indicated that appropriate health care appointments were made available to the resident as required or necessary. A visit to the home by the dentist and chiropodist was observed and meant that residents’ health care needs were being met. The home has an efficient medication policy supported by procedures that staff understand and follow. The manager and the supplying pharmacist make regular checks to ensure compliance with the policy and the most recent pharmacy check took place on 14/03/08. Examination of the medication administration records (MAR) showed they contained the required entries and were signed by appropriate staff at the correct times. The managers, senior day care and night staff were responsible for the administration of medication. Some of the care staff have also completed accredited training in this area. All areas of medicines handling, recording and storage were well managed. Homely remedies stored at the home were compliant with current acts and guidelines There are procedures for residents who take medication out of the home if they are going on a day out or on holiday, also destroyed or refused medication policy and a policy to manage medication dose changes made by the GP over the phone. Each system now compliments the existing medication procedure and protects residents from mis-managed medication and risk of harm. A small number of residents were observed using their bedrooms when they required personal care. Bedrooms that were locked for safety were done so following a risk assessment. It was apparent that residents could access areas of the home at any time of the day to maintain their privacy and were not discouraged from doing this. Care staff gave their supervision with this when required and treated the people using the service with warmth and dignity and residents privacy was respected at all times. Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A variety of well co-ordinated leisure and recreational activities were available and met many of the residents needs and interests. Visiting from relatives and friends was flexible. The meals and snacks ensured choice, variety and nutrition. EVIDENCE: The manager said that wherever possible people who use the service were able to make choices about aspects of their lives including waking and going to bed times and handling their own finances. Case tracking, examination of records, observations of the care provided and discussion with one resident confirmed this in most cases. The religious and cultural needs of the people who use the service had been assessed and identified when they moved into the home as part of the admission process and details were included in the care plan. This means that managers and staff were aware of the diversities amongst the residents and how these could be met. Two lay Preachers were seen visiting some of the residents during the inspection. This means that some residents’ religious needs were being met. Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 14 Since the last key inspection the service has employed a part-time activities coordinator whose job is to ensure there are meaningful daily activities available to all of the people who use the service. The activities coordinator was observed throughout both inspection days involved in reminiscence and recognition activities with many residents who volunteered or were gently persuaded to join in the events. A record of activities was displayed on the notice boards of both units but residents were reminded of the events throughout the day. Those who didn’t want to get involved could be seen watching the Olympics on television, reading newspapers or magazines, sitting quietly in their own space or talking to care staff during elevenses and afternoon tea. Care staff interactions were confirmed by a care worker who when asked about the residents routines and staff contact said, ‘staff always spend time with residents in the morning and afternoon once their care tasks are complete. Between 10am and 11.45 staff always get to spend time with residents to talk. 2pm- 4.30pm we spend time chatting, play board games, over a cup of tea with activities, the resident’s really enjoy it, and so do we’. Residents who were resting were not disturbed and those who smoked did so with the support of the care staff in the homes designated smoking area. Records of resident’s individual activities were noted in the daily report book and included brief details of the visits from relatives, outings, religious observance, hairdresser, art, games and TV. Relatives were observed visiting the home throughout the morning and afternoon and were made welcome by the staff team. A visit by the hairdresser and cake making in the afternoon showed there were a range of different activities available to meet the social needs of the people using the service. Mealtimes were observed in both units. Residents were given a choice of meal on the spot so they didn’t forget their choice. The newly decorated dining room was clean, bright and inviting, overlooking the courtyard. Meals served on both days looked appetising and nutritious. Those needing help with eating were given discreet support. Hot and cold drinks were seen being served at regular intervals throughout the day. Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): OP 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home follows a robust complaints procedure, so residents and their relatives can be confident that any concerns will be taken seriously and acted on. The homes safeguarding procedure and staff training ensured that people living in the home were properly protected from risk of harm. EVIDENCE: Riverside Care Centre’s complaints procedure specifies how complaints can be made and who will deal with them. There is an assurance that complaints will be responded to within a maximum of 28 working days. A copy of the complaints procedure is included in the homes Statement of Purpose and Service User Guide. The manager confirmed that complaints made would include details of the investigation and any action taken. When asked, a relative said that she knew who to complain to if they were unhappy with their relatives care at the home. She said, “I have no complaints, and I’m happy for my mum to be here”. There were procedures for staff to follow if they suspected an incident of abuse had taken place. Discussion with the manager confirmed that 60 of the care staff were trained in safeguarding vulnerable adults and there were plans to train the other 40 before the year end. This means that more of the care staff would be able to recognise abusive practices and would know how to report them. When asked, one of the care staff said that she would be able to Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 16 recognise abusive practices and behaviours and would always tell the manager if she suspected any form of abuse to residents. Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP 19 & 26 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Both units in the home have been maintained in good order providing a clean, safe, warm and comfortable environment, which meets residents’ needs and encourages independence. EVIDENCE: A tour of both units in the home showed it was suitable for it’s stated purpose and comfortably accommodated 40 people. Shared facilities, communal areas, bedrooms, bathrooms and the kitchen had been recently re-decorated and refurnished to a good standard. The home was light, bright and homely. Aids and adaptations like wheelchairs, hoists, handrails, bath aids, a stair lift and other equipment to promote mobility and independence were seen being used around the home. Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 18 Bedroom doors had been painted in bold colours to represent the front door of a house and each door was fitted with a brass doorknocker and number so that residents could identify their room more easily. The people who use the service were encouraged to personalise their bedrooms with their own furnishings and ornaments. Pictures of ‘old Lancashire’ were placed sensitively along the corridor walls to encourage reminiscence and help the people using the service to become familiar with their surroundings. A tropical fish tank sits in the entrance to the home where many residents took an interest and found it relaxing to watch. The manager gave the inspector a copy of work completed in the home since the last inspection and a list of scheduled work to follow. The home was well lit, clean and tidy and smelled fresh. When asked about her views on the homes environment one resident said, “It’s lovely and cosy here, very homely, I feel very lucky to be here”. Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP 27, 28, 29 & 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The staffing structure is based around delivering outcomes for residents. Care staff were competent and skilled to meet the needs of the people using the service and residents were in safe hands at all times. There is a good recruitment procedure that clearly defines the process to be followed. EVIDENCE: Although the staff rota showed there were care staff vacancies the home was staffed sufficiently and particular attention was given to busy times of the day and specific needs of the people who use the service. The new activity coordinator compliments the existing staff team allowing them to focus on delivering good quality care in a safe environment. The inspector observed staff involved in a number of daily activities with resident’s demonstrating good practice and enough staff available to meet their needs. Rotas showed well thought out ways of making sure that the home was staffed efficiently. The manager said that staff were usually cooperative and would work extra hours if there were staff shortages due to annual leave or sickness. An up to date staff-training matrix was available and identified future staff training and development needs. 82 of the care staff are trained in dementia awareness and NVQ level 2 or 3 in care. 60 of the care staff have received training in safeguarding vulnerable adults and 99 of staff have received mandatory training in safe working practices. This means the staff team are Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 20 competent and well trained and able to meet the needs of the residents in a person centred way following the homes philosophies, aims and objectives. There is a good recruitment procedure that clearly defines the process to be followed and ensures the protection of the people who use the service. One staff member when asked about her recruitment to the post confirmed pre employment checks required to ensure the protection of the residents were done before she was recruited. Records in staff personnel files were examined to confirm this. It was evident from the relationships and rapport observed between the staff and residents that people have confidence in the staff who care for them. Managers encourage staff to undertake external qualifications beyond the basic requirements and in turn produce a skilled and trained workforce. Accurate job descriptions and specifications clearly define the roles and responsibilities of staff. Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP 31, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interest of the people who use the service. The homes new policies and procedures ensure safe working practices. Systems are in place so that residents and staff can express their views and opinions. EVIDENCE: The registered manager has the required qualifications, skills and experience to run the home and she has a clear understanding of the key principles and focus of the service. The manager’s practice, skills, and knowledge, is based on continuous development, gained through training and genuine enthusiasm for the role. The management team regularly review the homes policies, procedures, records and practices to ensure staff awareness and the wellbeing of the Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 22 people who use the service. There is also a focus on person centred thinking and there is a strong ethos of being open and transparent. There are sound policies and procedures that are reviewed by the management team to ensure these are in line with current practice. There is also is an established corporate business plan that details the business arrangements for monitoring the performance and practice of the home. Staff meetings take place regularly. Supervision sessions are less frequent and the manager said that she would focus on improving this area within the coming months. This means that some areas of care practice and staff development might be unmet and unrecognised. Alongside this care staff might feel unsupported and not carry out their duties to the best of their abilities therefore residents’ needs might not be fully met. An annual internal audit to measure relatives and resident’s satisfaction shows that the homes objectives are being met. There is a clear health and safety policy that ensures safe working practices. The home has the necessary insurance cover in place to fulfil any loss or legal liabilities. Records and documents examined showed fire drills, equipment and appliance safety checks were done regularly. Wherever possible resident’ views about the service were recorded and acted on. The person in charge said that there is an open door policy where residents’ and staff could talk to the manager at any time, however these talks were not recorded. People are supported to manage their own money where possible. Where this was not possible there was a clear reason why. There were details and signed records kept of resident’s fees charged and paid and signatures verified the transactions. Risk assessments were completed and taken into account when planning resident’s care and routines within the home. Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP36 Good Practice Recommendations It is good practise for the manager to ensure there are written records of staff supervision to verify discussions between care staff and managers so that care staff feel supported and carry out their duties to the best of their abilities. Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Merseyside Area Office 2nd Floor South Wing Burlington House Crosby Road North Waterloo, Liverpool L22 OLG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Riverside Care Centre DS0000068661.V363383.R01.S.doc Version 5.2 Page 26 - 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. 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