Care Home: Ruby Rhydderch

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What the care home does well The home ensures peoples` needs are met in the way they choose by listening to peoples` views, gathering information about the individual and focusing on outcomes for people. The home constantly reviews practice to improve the service further. Regular visits are completed by a representative of the organisation to ensure the service provided focuses on the people who live in the home. People living in the home are cheerful and alert, staff interaction with the people using the service is attentive, professional and respectful. The Expert by Experience report includes, "Ruby Rhydderch is a lovely place`` " The accommodation is homely, spotlessly clean and has a welcoming feel to it`` "There is plenty to do for people`` "Staff are clearly supportive of people who choose to or are not able to participate in all the activities that are on offer``. " All of the staff that I spent time with were committed, hardworking, friendly and respectful``. "Great attention is given to individual needs of people``. One lady told the Expert by Experience. "They do wonderful things such as summer fetes and trips out and even have their own mini bus``. "We go to the theatre and have parties and there is always someone to talk to``. What has improved since the last inspection? Since the last inspection many parts of the home have been refurbished, and these include bedrooms, dining areas, and corridors. The requirements made at the last inspection have been met and included: More details in care plans have been included so staff have the information to care for people as they choose. Medication risk assessment have been completed so the staff have clear guidelines to ensure people receive their medication as prescribed. What the care home could do better: The home continues to provide a service that meets peoples` needs. No requirements have been made as part of this inspection. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ruby Rhydderch 2 Ipstone Avenue Stechford Birmingham B33 9DZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sue Scully     Date: 1 7 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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: Ruby Rhydderch 2 Ipstone Avenue Stechford Birmingham B33 9DZ 01217842195 01217899367 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Birmingham City Council (E) care home 45 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Care/shift manager hours and ancillary staff should be provided in addition to care staff Completion of the BTEC Higher Diploma in the Management of Care Services by April 2005 In addition to the above minimum staffing level there are 3 waking night staff a senior awake or on sleeping-in duty That minimum staffing levels are maintained at 7 care assistants a senior member of staff throughout a 14.5 hour waking day That one service user aged between 50 and 65 can be accommodated in this home to receive interim care for a period not ususally exceeding six weeks. That the home is registered to accommodate 45 adults over the age of 65 who are in need of care for reasons of old age and may include mild dementia. Registration category will be 45 OP 0 Over 65 45 Care Homes for Older People Page 4 of 26 Date of last inspection Brief description of the care home Ruby Rhydderch is a purpose built two-storey building that was commissioned in 1974. It is owned and managed by the Local Authority and provides accommodation for forty-five residents for reason of old age for both long term and respite care. The home is divided in to four units, which are individually staffed and have a lounge and kitchen. In addition, there are a number of communal sitting areas around the home. The floors are accessed by a shaft lift and the home has hoists to assist those who suffer from restricted mobility in completing transfers to respective rooms. Assisted bathing facilities are available in each unit which provide residents with a choice of bath or shower. The corridors are wide and provide good access for wheelchair users. There are pleasant enclosed gardens to the rear that are accessible to all residents. The main kitchen and laundry rooms are situated on the ground floor. There is a day centre attached to the home, which is managed and run as a separate entity and is not inspected by CSCI. Off road parking for two cars is available to the front of the home with further parking to the side of the building. The home is situated close to local amenities such as shops and is well serviced by public transport. Fees at the time of inspection ranged from £64.65 to £482.00 per week. Hairdressing, chiropody, dry cleaning, dental care, optician appointment and toiletries are not included in the weekly fees. 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: The inspection was completed over one day. The inspector was accompanied by an observer from the commission for social care inspection administration team who wished to gain further knowledge about how we inspect social care services and an expert by experience. We are currently using a method of working to complement our inspection where experts by experience are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. The term experts by experience used in this report describes a person whose knowledge about social care services comes directly from using them. As part of the inspection process we talk to people using the service, sample records and send surveys to randomly selected people who have used the service over a period of time. We look at polices and procedures, and the general operation of the home in relation to meeting peoples needs. Care Homes for Older People Page 6 of 26 The home is also required to complete an Annual Quality Assurance assessment (AQAA). The Commission sends this document to the provider before the inspection. The AQAA enables the manager to tell us what future plans they have and any improvements that have already been made. The manager had completed the AQAA and some of the information has been included in the report. 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 set out 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 arrangements for assessments of people moving into the home gives confidants that there needs will be met. This means the home has the information to ensure people needs are met the way they choose. Evidence: We looked at the information available for people wishing to move into the home to see if they would be able to make a decision based on the information provided. The service users guide tells people what service is provided and by whom, what qualifications the staff hold, the history of the organisation and what the person moving in to the home can expect. Assessments are undertaken before a person moves into the home to ensure they can meet their needs. The records of four people were looked at, and in each file there was information that covered all areas of needs such as medical condition, past history, next of kin, social worker details and information of why they need to live in a Care Homes for Older People Page 11 of 26 Evidence: residential home. The assessment forms part of the person care plan. More information is put in to care plans as the staff and the person using the service have reviews of their care. The individual can visit the home to look around before they move in if they wish. Risk assessments are undertaken as part of the assessment process so staff have the information ready for when the person moves into the home so they can care for them safely. The assessments focus on peoples preferences, choice, and peoples past history. This enables the staff in the home to promote independence so people can continue to lead a fulfilled life style 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 using the service are involved in the planning of their care, which helps their lifestyle and quality of life. The principles of respect, dignity and privacy are put into practice. People are encouraged to make their own decisions and choices. Evidence: We looked at three care plans. Care plans are documents that tell staff what they need to do for people, care plans take into consideration people medical history, their current illness, and how they want to be cared for. To enable us to assess if peoples needs are being met, when we look at the care plans we also look at the staff files, risk assessments, staff training records, and the persons medical condition. We do this so we can assess if the persons needs are being met by staff that have the skills to support them safely. The three care plans we looked at showed us detailed information about what assistance with personal care the person needed and identified their individual likes and choices. For example one care plan showed us the person was a diabetic, along Care Homes for Older People Page 13 of 26 Evidence: side the care plan was a risk assessment identifying the risk involved such as being insulin dependent, controlling the persons diet and the involvement of other health care professionals such as the district nurse. Continuing in the same care plan there was information about health care checkups, doctors visit, the person history and daily activities. The care plan gave information who was involved in reviews and the action point from the reviews were recorded so that staff were aware if there was a change to how they supported the person. In another care plan there was detailed information about the persons religion and culture, and how staff ensure these beliefs are met such as skin care, hair care, and church visits. There were a number of assessments undertaken by staff, such as pressure care, nutritional screening-peoples weights and diet. Where people had a poor appetite, action was taken by way of a referral being made to dietitian. Risk assessments and the control measures to minumise risks to both the people using the service and staff were completed when required. This ensured the staff had the information for safe systems of working. There was evidence in care plans of how staff ensured peoples privacy and dignity was maintained, such as preferences of a female or male carer. We observed staff talking appropriately to people listening to what they were saying and respecting their privacy when they were reading or just sitting quietly in the lounge. Daily records and professional visit sheets generally show that health care needs were being identified, followed up and monitored. There was evidence that the people living in the home saw G.P.s, district nurses, chiropodists, dentists and other health care professionals when required. The Expert by Experience spoke with people using the service and comments include: People using the service are cheerful and alert and very complimentary about the home and staff in the way they look after people. One person said The carers are wonderful and work very hard nothing is too much trouble, they are all very kind. There was a lot of chatting with staff and the people living in the home which made the overall experience of people being relaxed and alert. It was so refreshing to see that no one were being talked over or ignored. 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. People living in the home have opportunities to undertake activities of their choice on a regular basis. The staff undertake a lot of work with people to ensure relationships are maintained with family and friends. Menus demonstrate a varied and balanced diet is available each day. Evidence: There were no rigid rules or routines in the home. People were seen to walk freely around the home, spend time in their rooms, take part in activities and spend time quietly in the lounge. People were seen to be given choices about where they wanted to sit,what they wanted to watch on TV, and if they wanted to listen to music or just relax reading a book. The Expert by Experiences spent time with the people living in the home, talking to them, looking at their bedrooms with a general tour around the home. Both the Expert by Experience and the observer joined the people living in the home for the midday meal. Feedback from the Expert by Experience included. Ruby Rhydderch gives an instant feeling of warmth, homeliness. As we travelled around the home it was striking that the accommodation was odour free apart from the faint scent of furniture polish. Ruby Rhydderch held a clean smell. There were the usual aromas of clean washing Care Homes for Older People Page 15 of 26 Evidence: around the laundry area and that of toast in the kitchen. Lunch was a choice of homemade Cornish pasty or very delicious looking boiled bacon, both with mash and fresh runner beans and cabbage. Lunch was pleasantly hot but not too hot so as to burn ones mouth. Each individual plate was taken immediately to the table after serving up. There were no cold dinners here! My bacon was moist, tender and extremely tasty. The vegetables were tender but not mushy or hard and the gravy was definitely not out of a jar. I also noted that each resident was asked if they wanted gravy rather than the normal assumption that gravy went on everybodys dinner. Jugs of squash were refilled when asked. There was plenty to drink. Dessert was jam sponge and custard. This again was extremely tasty and many of the residents were offered and accepted second helpings. With the exception of a couple of people who were clearly having difficulties with their appetites I noticed that clean plates were in the majority. A couple of ladies were slower at eating and there were no moves made to hurry them. The staff on duty were cheerful, respectful of individual needs and very hard working. Menus sampled show a variety of choices each day with special diets where required. Visitors are made to feel welcome and join in activities if they wish. 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. Suitable arrangements are in place to respond to peoples concerns and complaints and staff have been trained to recognise and respond to suspicions of abuse so that people are protected from harm. Evidence: The complaints and adult protection procedures for the home had been seen at previous inspections and were found to be satisfactory. The people living in the home or their representatives receive a copy of the complaints procedure in the service user guide. The comments received indicated that any concerns raised were listened to and acted on. They included: The manager is always ready to listen and give advice on any problems I have. Ive had no reason to complain. There has never been cause for concern and I have every confidence in all the staff. There had been one complaint since the last inspection when we sampled the complaints file. This had been investigated by the manager and the outcome given to the complainant. The policies and procedures for safeguarding adults are available and give clear Care Homes for Older People Page 17 of 26 Evidence: specific guidance to those using them. Staff know when incidents need external input and who to refer the incident to. The staff have received training in the protection of vulnerable people to ensure the action they take when an allegation is made does not interfere with an external investigation. Care Homes for Older People Page 18 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 overall standard of the environment was very good providing the people that live there with an attractive, safe, comfortable and homely place to live. Evidence: The home is divided in to four units, which are individually staffed and have a lounge and kitchen. Meals are served in the main dining room located on the ground floor or the smaller room on the first floor. All accommodation is provided in single rooms that are equipped with a wash hand basin and call bell. In addition, there are a number of communal sitting areas around the home. The floors are accessed by a shaft lift and the home has hoists to assist those who suffer from restricted mobility in completing transfers to respective rooms. Assisted bathing facilities are available in each unit which provide residents with a choice of bath or shower. The corridors are wide and provide good access for wheelchair users. The expert by experience comments include, The dining room on the ground floor is spacious with dining tables well spaced, giving both dignified privacy between tables and ample access for wheelchairs without the risk of bumping anyone or making any unsafe manoeuvres when accessing the table. The tables were dressed nicely with colourful cloths, mats, condiments and cutlery. They were adorned with coordinating vases of flowers and the curtains and seat covers held coordinating colours. In all it looked very welcoming and a pleasant environment in which to dine. Care Homes for Older People Page 19 of 26 Evidence: Ruby Rhydderch held a clean smell. The carpets and decor were intact and well maintained. The furniture was bright, clean and appropriate for the needs of the ladies and gents living there. I was pleased to see that there were footstools and knee blankets in use, where needed, and chairs were set safely but not in the classic regimented circle in the lounges. The corridors were free of obstructions. All hoists and wheelchairs were seen to be tucked away in areas designated for safe storage. Care Homes for Older People Page 20 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. People needs are met by competent and skilled staff to ensure they are in safe hands at all times. Evidence: During the last inspection the homes recruitment procedures ensured only suitable people were employed after undertaking the necessary checks. The home have not employed at new staff since the last inspection so we did not look at the recruitment files. We looked at the training records and these showed us staff receive training on a regular basis and includes health and safety, first aid, food hygiene, manual handling, dementia, and challenging behaviour. This means staff have the relevant skills to ensure the people living in the home are cared for safely. We looked at the supervision matrix that showed us staff have regular supervision including personal development. The rotas demonstrate the numbers of staff on duty each day ensures people receive good support. Staff working at the home are committed to providing the people living in the home with a fulfilled lifestyle. 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 well managed with a committed staff team that ensure people needs are met, monitored and reviewed, Evidence: The manager was on duty throughout the course of the inspection. She had many years experience of caring for older people and demonstrated a very good knowledge of the people in her care and the running of a residential home. The management team was well structured with the manager, deputy manager and several senior care staff. Some very positive comments were received about the management of the home including: The manager always listen, and talks to you and you can pop in to the office for a chat. The deputy manager is really nice and you can hear them laughing in the office which means the home is very friendly. Care Homes for Older People Page 22 of 26 Evidence: The manager and staff are really nice and kind. A sample of records relating to the health and safety of the home were examined. These related to fire safety, prevention of legionnaires disease and food storage. The records seen confirmed that the home takes reasonable action to maintain the health and safety of the people living in the home and staff. The home holds a small amount of money for the people living in the home so they can have their hair done when they want to or buy things, such as news papers. At the end of each shift the two senior members of the staff complete an audit. This ensures people living in the home are fully protected and the money held by the home is safe. Certificates were available to demonstrate that the gas appliances are fitted and checked each year by a CORGI registered tradesman. There were systems in place to monitor the quality of the service offered at the home. This included consultation with the people living in the home (where possible) their relatives and representatives. The Expert by Experiences comments include, All of the staff that I spent time with were committed, hardworking, friendly and respectful. Great attention is given to individual needs and choices of the ladies and gents living there. I witnessed many inclusive and genuine, caring behaviours. The ladies and gents that I had the time to speak with all spoke highly of their home and its facilities and the staff that cared for them. 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 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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