Care Home: Riverside House

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What the care home does well People are provided with good information about the home which helps them decide whether it is a suitable place for them to live. They are invited to spend time in the home to decide if their needs can be met. Thorough assessments are carried out prior to people being admitted to the home. This information is used to develop a plan of their personal care to help ensure needs are fully met. Training is being provided to the staff to help ensure they have the correct skills to meet individual needs. The home has a robust recruitment and selection process to help protect people from abuse and to help ensure appropriate staff are appointed to meet the needs of the people living in the home. The manager and staff team are committed to making improvements and ensuring good standards are met. They encourage people to express their opinions on the service they receive and how this can be improved. Visitors are made welcome in the home and invited to any events taking place. A wide range of activities are offered and the staff try to introduce new activities to suit different tastes. People living in the home said the food is very good and they are given plenty of choice. Comments from people living in the home and their relatives included:"I would rate Riverside as excellent, and the staff as outstanding and would have no hesitation in recommending it to anyone." "Mam has been treated as an individual and the staff have endeavoured to cater for her likes and preferences". "Provides my mum with security, sense of wellbeing, Provides company and activities during the day making mum feel needed and special". "I didn`t want to give up my own home but I get well cared for here. The staff are all wonderful". "Clean, warm, friendly. Good food". What has improved since the last inspection? The home had to close in September 2008 due to flooding. It reopened in April 2009 and has been refurbished. The requirements made for the administration and storage of medications have been met and staff have been reassessed as competent when dealing with these. Suitable hoisting equipment has been provided to suit the needs of the people who are admitted to the home. An open and inclusive atmosphere has been promoted where people feel able to make their opinions and concerns known to the manager. Staff have been provided with training to develop person centred care plans to help meet people`s individual needs. What the care home could do better: Ensure that `end of life` wishes and preferences are discussed and recorded in the care plans to ensure that these are met. Ensure risk assessments are signed by the person living in the home (or their representatives) to show they have been involved in the discussion. Key inspection report Care homes for older people Name: Address: Riverside House Low Stanners Morpeth Northumberland NE61 1TE     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: Anne Brown     Date: 0 3 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Riverside House Low Stanners Morpeth Northumberland NE61 1TE 01670503103 01670503103 riversidehouse@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross BC OpCo Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 46 The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 46 Dementia Code DE, maximum number of places 10 Date of last inspection Brief description of the care home Riverside House provides a home for up to 46 older people who require residential care. Nursing care is not provided. The building is large with a ground and upper floor. It has a passenger lift. All of the bedrooms are single and have an en-suite toilet and shower. There are also four separate bathrooms. There is a pleasant garden area and Care Homes for Older People Page 4 of 27 Over 65 0 46 10 0 Brief description of the care home ample car parking spaces. The home is a short walk away from Morpeth town centre and therefore close to most of the amenities the town has to offer. Buses provide the main means of public transport. Information about the service, including inspection reports, is readily available. The fees are currently £552.00 per week. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: The quality rating for this service is 3 star. This means that the people who use this service experience excellent quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out. Before the visit:We looked at:Care Homes for Older People Page 6 of 27 Information we have received since the last key inspection on 28th April 2008. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service and their relatives. An unannounced visit was made on 2nd March 2010 and a further visit was made on 3rd March 2010 to speak with the staff on duty. During the visit we:Talked with people who use the service, their visitors, the staff, the manager and deputy manager. Looked at information about the people who use the service and how well their needs are met. Looked at other records that must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last inspection. Attended a residents meeting and a staff meeting which were taking place at the time. We told the manager what we found. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? The home had to close in September 2008 due to flooding. It reopened in April 2009 and has been refurbished. The requirements made for the administration and storage of medications have been Care Homes for Older People Page 8 of 27 met and staff have been reassessed as competent when dealing with these. Suitable hoisting equipment has been provided to suit the needs of the people who are admitted to the home. An open and inclusive atmosphere has been promoted where people feel able to make their opinions and concerns known to the manager. Staff have been provided with training to develop person centred care plans to help meet peoples individual needs. 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 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering moving into this home are given good information and have their needs assessed which helps ensure their needs can be met. Evidence: The homes Statement of Purpose and a Guide for Service Users were openly displayed in the foyer. They contained good information about the home and the services offered. The care records of three people living in the home showed that assessments had been completed about each persons needs and then used to draw up a care plan. These assessments included nutrition, continence, falls, mental health etc. The manager is currently working with the staff to review the records to ensure all the necessary documentation is available and up to date for each person living in the home. Care Homes for Older People Page 11 of 27 Evidence: A survey returned by a relative of a person receiving respite care said I was impressed that a member of staff came to visit Mam at home prior to her stay to collect the information they required and to explain what would happen during her stay. A visitor in the home said their relative had been invited to spend time in the home and had spoken to people living there before deciding to move in. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are well supported by the staff and there are good arrangements in place to help ensure the health needs of the people living in the home are met. Evidence: Four service users care records were looked at. Risk assessments are carried out regularly to determine the risk of falls, pressure ulcers and malnutrition. The information from these assessments was used well to draw up comprehensive care plans. The manager is currently reviewing the care plans to ensure they are more person centred. She has also started a programme to train the staff team in person centred planning. One member of staff said they are finding this useful as it is more detailed than previous training they had received. It was recorded on one file that the person had been involved in a discussion regarding their risk assessment but they had not signed the record to confirm this. Two files did not include information on end of life preferences. Care Homes for Older People Page 13 of 27 Evidence: The people living in the home and their visitors said the staff ensure appropriate health care professionals are consulted when necessary. The staff on duty were aware of the individual needs of the people living in the home. They were observed to be treating them with respect and meeting their needs in a sensitive manner. Comments made by people living in the home included:Its a very good place to be. The staff look after you well. We couldnt wish for better staff. A survey returned by a relative said I was impressed when I attended the initial review meeting and the continuing care review of how much knowledge they had acquired of Mam as a person and the things they had put in place to support her. The staff are always cheerful, positive and helpful and treat all residents as individuals. The medication records were up to date and appropriately signed. The system is regularly audited by the manager and deputy manager. The manager confirmed that a storage cabinet has been ordered to provide more space to store supplies of medications which are not kept in the medication trolley. A senior carer confirmed that she had received training in safe handling of medication and evidence of training was seen on another senior carers staff record. People are encouraged to retain their own medications if they are assessed as competent to do so. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home are provided with a good range of activities and a good choice of food. Evidence: An activities co-ordinator is employed for 30 hours per week. In his absence activities are organised by the staff. These include dominoes, arts and crafts, board games, flower arranging, carpet bowls, play your cards right, parachute game, quiz, music therapy, pampering etc. Some people living in the home had recently enjoyed decorating biscuits, making pizzas and baking cakes. The staff accompany people to visit the local shops, pubs and cafes. The home has access to a mini bus and outings are arranged to local places of interest. Lots of social events are held in the home when relatives and friends are invited to attend. Recent events include Pea and Pie Supper, Wine and Cheese afternoon, Themed evenings etc. The staff work very hard to raise money for these events. Entertainers are booked to perform in the home on a regular basis. Care Homes for Older People Page 15 of 27 Evidence: A music therapist visits the home once a week to deliver music therapy to individuals and groups. Activities are discussed at the residents meetings which are held every month. An activities programme is drawn up and given to each person living in the home. One lady had a copy of the programme in her handbag and was referring to it to find out what activities were planned. The staff were planning to involve some people living in the home to grow vegetables and flowers and are hoping to provide a greenhouse. An anniversary party to celebrate the home being open for ten years is to be held. A planning committee is being formed to include people living in the home and the staff. A monthly newsletter is also produced to help ensure everyone is aware of what is going on. Representatives from religious denominations visit the home on a regular basis and two people attend church services with their families. Three visitors confirmed that they can visit at anytime and are able to see their relatives in private. A survey returned by a relative said I was not surprised at the level of care Mam received, but was touched at the care and support I was given and the lengths they went to in making my visits a positive experience. Each person in the home has their nutritional needs assessed and this is fed into the menu planning with the chef manager. Lunch was being served during the inspection. The food was well presented and the portion sizes were ample. The atmosphere was relaxed and unhurried. The staff were assisting people in a sensitive manner. Alternative meals can be requested if someone does not want to choose from the menu. Drinks and snacks are available throughout the day and night. The chef attends residents meetings so people can discuss the menus and make suggestions. People attending the meeting at the time of the inspection said the food was very good. A survey returned by a relative said I have heard residents commenting on the excellence of the catering, having sampled the home made Care Homes for Older People Page 16 of 27 Evidence: biscuits, I can only agree with them. Another person said The food is so good I am putting on too much weight. Care Homes for Older People Page 17 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected from abuse and there is an effective complaints procedure in place. Evidence: The complaints procedure was displayed and easy to understand. One complaint had been received since the last inspection. This had been investigated, recorded and satisfactorily resolved. People who were spoken to were aware of the procedure to make a complaint and said they would raise any concerns with the manager if they had any. People who attended the residents meeting were asked if they had any concerns and the manager holds an open evening each week where relatives can meet with her and discuss any concerns they may have. All staff have attended training on safeguarding and abuse. This was confirmed by the staff on duty who were aware of the procedure to follow if they observed any bad practice in the home. The manager and staff seek advice from other health professionals where any resident presents verbal or physical aggression and staff described how they dealt with any situations that may arise. Some staff have had training about dealing with challenging behaviour. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with a safe and pleasant place to live which is clean and hygienic. Evidence: Access into the home is good and meets the needs of the people living there who have mobility problems. People who have walking aids such as zimmer frames or wheelchairs are able to move around the home with ease. There are specialist bathing facilities and shower rooms to meet the needs of the people living in the home. All areas were very comfortable, well decorated with a very good standard of hygiene. There is a programme for redecoration and improvements around the home. A handyman/gardener is employed to address any problems on a daily basis. The people living in the home all have their own bedrooms with en suite facilities. They are encouraged to bring personal belongings and to individualise their bedrooms with small items of their own furniture if they choose to. Some people confirmed they could spend time in their own room and see their visitors in private. The surveys returned by the people living in the home confirmed that the home was always fresh and clean Care Homes for Older People Page 19 of 27 Evidence: All areas in the home were comfortable, pleasantly decorated and clean and hygienic. Staff have completed training to help prevent the spread of infection. An Environmental Services Officer has recently visited the home and recommended a sluice be provided. The manager is currently awaiting this to be confirmed in writing so she can put the request to her line manager. There are pleasant gardens which are accessible to the people living in the home. Discussions are currently taking place about ways the gardens can be developed, e.g. flower beds, vegetable plots, greenhouse etc. One person living in the home said they enjoyed walking around the gardens on a daily basis. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a robust recruitment policy and procedure in place to help protect people living in the home. The staff are competent, skilled and committed to meeting individual needs. Evidence: On the day of the inspection the following staff were on duty:Manager, Administrator, Deputy Manager, Four care assistants, Activities coordinator, Domestic assistant, Laundry assistant, Chef, Kitchen Assistant and Handyman Three care assistants are on duty to care for people during the night. Four staff files were examined. Criminal Records Bureau checks had been carried out and two written references obtained. This helps to protect the people living in the home. There is a programme in place to ensure all care staff achieve a National Vocational Qualification, (NVQ), Level 2. Eight staff have already achieved this and five are undergoing training to achieve this. Training programmes are in place to ensure all staff receive regular mandatory health Care Homes for Older People Page 21 of 27 Evidence: and safety training and specialist training to meet the individual needs of the people living in the home. The manager is currently updating the training matrix and training needs are being discussed with each member of staff during their supervision sessions. The staff on duty confirmed that they receive appropriate training to carry out their roles efficiently. One person said they would like refresher training in some specialist areas. The people living in the home and their relatives were complimentary about the staff. Comments included:The staff are caring and listen to the residents. Everyone is welcomed with a smiling face, the general atmosphere is relaxed but always attentive. Couldnt wish for better staff. I have no problems with the care staff. More staff would be better for everyone. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience 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 home that is very well run and managed for their benefit and their health and safety is promoted. Evidence: A new manager has been appointed since the last inspection and she is currently in the process of registering with the Commission. She is experienced in managing care homes and holds appropriate qualifications. She is committed to providing good care and putting the needs of the people living in the home first. She promotes an ethos amongst staff of involving them in the decision making process. The staff and residents confirmed that the manager is supportive and very approachable. A meeting was held with the residents during the inspection. The people who attended were readily expressing their opinions and making suggestions. A staff meeting also took place and staff members were eager to think of ways they could improve the services offered to the people who live in the home. Care Homes for Older People Page 23 of 27 Evidence: Good relationships were observed between the manager, the staff on duty and the people living in the home. There is a quality assurance system in place, with regular audits of systems in the home being carried out. Surveys are given to people living in the home and their relatives/representatives and the information is collated and used to make improvements. The administrator handles personal allowances for some residents. Records were kept of monies held on behalf of residents, which showed the dates money was deposited or withdrawn/spent and what it was used for. Receipts/records were kept where item/services had been obtained on behalf of individual residents. The company carries out regular audits of the system. Three staff records were looked at, which showed that staff received training in essential areas which affect health and safety. More training is planned and being carried out. Up to date evidence of maintenance/safety checks on fire systems, the lift, gas system and moving and handling equipment, was in place. A newsletter is produced each month to inform people of things that are taking place and any changes that are being considered. A programme is in place to ensure formal supervision sessions are kept up to date. The staff on duty confirmed that they receive regular supervision. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 8 Risk assessments should be signed by the people living in the home to confirm they have been involved in the discussion. Information should be available to ensure peoples wishes and preferences are carried out at the end of their lives. 2 11 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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