Care Home: The Riseborough Care Home

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What the care home does well The home carries out thorough assessments prior to residents moving in and this includes finding out about all aspects of care. Prospective residents andtheir families are encouraged to visit the home before making a decision about admission. The activities arranged within the home meet the expectations of the residents living there. Residents are encouraged to maintain their links with friends and family and all visitors are made welcome. Residents are helped to exercise choice and control over their lives as far as possible. Meals are wholesome and nutritious and planned around the likes and dislikes of residents. The complaints procedure reassures residents that their views are important to the home and that any complaints they raise will be properly investigated. The home protects the residents from abuse by ensuring robust policies and procedures are in place, which staff find easy to follow. Sufficient numbers of staff are on duty throughout the day and night to be able to meet the needs of the residents. What has improved since the last inspection? Since the last key inspection in February 2008 considerable improvement has been seen at the Riseborough. A new registered manager is in post and is managing the home well. He has a competent and well-trained staff team to support him in the delivery of a good standard of care for those people living in the home. An effective training schedule is in place. The programme of refurbishment has been completed resulting in the home being a very comfortable environment in which to live. What the care home could do better: As a result of this inspection we have not made any requirements. We have made two recommendations for good practice.The care documentation has improved greatly but there were still some minor shortfalls in recording, which need to be addressed so that a clear picture of the residents needs and how they respond to care is maintained. To ensure that all medications are handled safely and residents are protected a clear audit trail of medicines in the home should be maintained so that it is clear what stock is held. CARE HOMES FOR OLDER PEOPLE The Riseborough Care Home 11-13 Branksome Wood Road Bournemouth Dorset BH2 6BT Lead Inspector Amanda Porter Unannounced Inspection 20th October 2008 10:00 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 The Riseborough Care Home DS0000068327.V372772.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. The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Riseborough Care Home Address 11-13 Branksome Wood Road Bournemouth Dorset BH2 6BT 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) 01202 318567 01202 318568 the.riseborough@fshc.co.uk Four Seasons (No 7) Limited Mr Christopher John Stevens Care Home 74 Category(ies) of Old age, not falling within any other category registration, with number (74) of places The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. No more than 43 service users in need of nursing care may be accommodated. The home may accommodate two service users for respite care in the age range of 40-64 years to receive either nursing or residential care. The home may accommodate two service users in the age range of 40-64 years to receive either nursing or residential care. 4th February 2008 Date of last inspection Brief Description of the Service: The Riseborough is situated in a pleasant residential area of Bournemouth not far from the town centre. At the top of the driveway, there is a parking area and to the side and rear of the home are mature gardens that are well maintained. The home is owned by Four Seasons (No 7) Limited. The Registered Manager for the home is Mr Christopher Stevens. Accommodation is provided over three floors, which are accessible, by either stairs or passenger lift. All rooms in the home have en suite facilities. There are several lounges and a pleasant dining room, a small chapel and hairdressing facilities. At the time of inspection the fee range was £440 to £800. Fees are determined in relation to the prospective residents’ needs, as the home is able to accommodate both residential and nursing residents. See the following website for further guidance on fees and contracts: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_ choos.aspx The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. Two inspectors carried out the unannounced key inspection during the morning and early afternoon of the 22nd September 2008. The purpose of the inspection was to assess all of the key standards and improvements made since the last key inspection in February 2008. The Registered Manager, Mr Stevens, was on hand throughout to aid the inspection process. Information gathered for this report came from several sources including: • Reports made to the Commission for Social Care Inspection by the home. • The annual quality assurance assessment completed by the home. • 4 questionnaires completed by people living in the home, 3 by staff and by visiting health professionals • A random inspection, which took place in May 2008. • Tour of the premises. • Review of a variety of documentation including care records, staff records, maintenance records, policies and procedures. • Discussion with residents and staff. During the course of the inspection approximately five residents and six members of staff spoke with us and we asked their views on the service provided at the home. Comments we received through discussion and questionnaires included: “Staff are kind.” “I am well cared for.” “Staff are marvellous.” “The manager is good and manages the home well. There are no smells, a good environment and, most importantly, there is good care.” “Now I have peace of mind that my relative is being well cared for.” What the service does well: The home carries out thorough assessments prior to residents moving in and this includes finding out about all aspects of care. Prospective residents and The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 6 their families are encouraged to visit the home before making a decision about admission. The activities arranged within the home meet the expectations of the residents living there. Residents are encouraged to maintain their links with friends and family and all visitors are made welcome. Residents are helped to exercise choice and control over their lives as far as possible. Meals are wholesome and nutritious and planned around the likes and dislikes of residents. The complaints procedure reassures residents that their views are important to the home and that any complaints they raise will be properly investigated. The home protects the residents from abuse by ensuring robust policies and procedures are in place, which staff find easy to follow. Sufficient numbers of staff are on duty throughout the day and night to be able to meet the needs of the residents. What has improved since the last inspection? What they could do better: As a result of this inspection we have not made any requirements. We have made two recommendations for good practice. The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 7 The care documentation has improved greatly but there were still some minor shortfalls in recording, which need to be addressed so that a clear picture of the residents needs and how they respond to care is maintained. To ensure that all medications are handled safely and residents are protected a clear audit trail of medicines in the home should be maintained so that it is clear what stock is held. 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. The Riseborough Care Home DS0000068327.V372772.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 The Riseborough Care Home DS0000068327.V372772.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): 3 & 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New residents move into the home having had their needs assessed and been assured that these needs will be met fully. EVIDENCE: We reviewed the care files for four people who had recently come to live at the home. These showed that the home had a good procedure in place. Prior to anyone moving into the home a full assessment of needs was undertaken with the prospective resident. Sufficient information was obtained so that a care plan could be drawn up and made available to staff. Residents spoken with confirmed that the Registered Manager had encouraged them to visit and given them all the information they needed to make an informed decision about admission. The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 10 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): 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. Robust systems are in place to provide staff with the information they need to meet the health and personal care needs of residents. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Since the last key inspection we saw that the standard of care documentation had improved considerably. We reviewed the care files for six people living at the home and found they contained the relevant assessments and care plans needed so that staff had the information to be able to give a good standard of care. Care plans were written following consultation with the resident or their representative and were reviewed regularly. Generally the daily written statements in the care files lacked detail about what sort of day the resident has had, how they have been occupied and whether they were in a state of The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 11 well or ill being. In discussion with the staff it was evident that this area of documentation would need further work and the home was addressing this. People told us that they were well cared for. Where the need for specialist equipment was identified it was provided. It was clear from discussions with staff and residents that they have access to the health services they need. There was evidence to show that residents get support from General Practitioners, district nursing services, dieticians, opticians and chiropodists. The home has a good medicines policy and procedure in place. Examination of records indicated that medicines were properly administered so that residents were assured that they would get the correct medication they needed in accordance with their GP’s instructions. We looked at the medication administration records and found that these were being completed correctly with no gaps within the records. However there was no clear audit trail to identify how much medication was held by the home. People told us that they were very happy with the care they received and confirmed that staff treated them with respect and were supportive and kind. People said “They treat me well and know how to care for me.” “Staff are pretty good.” “Everyone is helpful, nothing is too much trouble. I am very pleased with the service.” The response time to call bells is monitored by the home and we reviewed this documentation and found that call bells were answered within 2 minutes. The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 12 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): 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. People who use this service are supported to maintain their life skills and are encouraged to make choices as far as possible. Social, spiritual and recreational activities meet the needs of the residents well. EVIDENCE: The Riseborough Care Home provides a good level of social, religious and recreational support to residents. Residents told us that they were happy with the lifestyle that living at the home afforded them. Some chose to spend time on their own but knew they could join in with any organised activities if they so wished. An activities co-ordinator is employed and a programme of activities arranged, which included: • Gentle exercise classes • Minibus outings • Visiting entertainers • Complimentary therapies The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 13 • • • Parties Film shows in the home’s cinema Arts and crafts. Activities were based on the preferences of the residents and were recorded. A programme of events was distributed to each resident every month. Residents said that they could entertain their visitors in private and that they were always made very welcome. People told us that they were free to choose whether they wanted to handle their own financial affairs. Some preferred to have a family member to act on their behalf. All residents spoken with confirmed they enjoyed the food provided. Records showed that residents’ likes and dislikes with regard to food were known and residents were aware that alternatives to the main menu were always available. Food was regularly discussed with people living in the home and alterations were made to the menu according to people’s wishes. The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 14 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): 16 & 18. 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 are able to express their concerns, and have access to a robust, effective complaints procedure. Protection from abuse is promoted. EVIDENCE: Residents told us that they knew how to complain and felt confident that if they had concerns or complaints they will be listened to and taken seriously. Three complaints had been received since the last inspection and had been investigated according to the home’s complaints policy and action had been taken accordingly. The home had written policies and procedures for the protection of residents from abuse or neglect and provided all staff with training in the understanding of abuse and their role in protecting residents from abuse in its many forms, including neglect. Care staff told us that they had received such training and demonstrated an understanding of local policies. The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 15 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): 19 & 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The standard of the environment at the Riseborough Care Home is excellent providing residents with an attractive, homely and safe place to live. EVIDENCE: We toured the premises and reviewed the maintenance documentation, which showed the home was well maintained inside and out. Since the last key inspection the programme of refurbishment has been completed. This has included the replacement of all lounge furniture, all carpets, all wall coverings, many items of bedroom furniture and conversion of some bathroom areas to shower facilities. The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 16 The home has many communal areas including a number of lounges, a bar, hairdressing salon, a beauty treatment room, a chapel, cinema and dining room. The garden was well laid out, attractive and accessible by those living in the home. People told us that the facilities the home offered were very good and that they were comfortable. All areas of the home seen during the inspection were clean, bright and free from any unpleasant odours. Surveys completed indicated that the home was always kept clean. The laundry was well managed. Adequate supplies of clean linen were seen to be available throughout the home. The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 17 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): 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. Sufficient care staff are employed to meet the needs of residents. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home. Staff are given the training and support so that they can give a good standard of care to the residents living at the Riseborough Care Home. EVIDENCE: There have been a number of staff changes since the last key inspection. However Mr Stevens has been successful in recruiting new staff and he has not had to employ many agency staff recently. This means that the continuity of care for those people living at the Riseborough has improved. One visiting health professional commented, “The staff team needs to become settled after a large number of changes over the past 3 years.” At the time of inspection staff rosters demonstrated that there are sufficient staff on duty at that time. During the inspection staff were available to meet the needs of the residents. People told us that staff were on hand when they needed them and they were not kept waiting. The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 18 The home had an ongoing training programme, which included NVQ level 2 and 3 in care and approximately 50 of the care staff hold the minimum of a level 2 award in care and more staff were working towards completing this programme. We reviewed the recruitment files for five new members of staff. The files were well ordered and contained all the information required by law. POVA first and enhanced Criminal Record Bureau checks had been obtained for all new staff. Training files showed us that staff were receiving induction training. Staff told us, “Our training is very essential not just for us but mostly for the residents. Our employer makes sure that we are well equipped with the necessary knowledge and makes sure that we apply it though our work properly.” Recent training including: • Fire safety • Effective communication • Moving and handling • First aid • Protection of vulnerable adults • Challenging behaviour management • Tissue viability • Sight and hearing loss Further information on available training can be accessed through the following websites: www.picbdp.co.uk www.skillsforcare.org.uk The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 19 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): 31, 33, 35 & 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 well organised and the daily management and running of the home centres around the care of residents. Good management practice, systems in place, and records kept, confirm the health and safety of all in the home. EVIDENCE: Through discussion it was evident that residents and staff enjoyed the way the home was being run and found the Registered Manager was approachable. Mr Stevens demonstrated throughout the inspection that he ran the home well. The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 20 People told us, “The service has vastly improved since a new manager and new clinical lead nurse have been appointed.” “The manager is often ‘on the floor’ and is clearly visible and easy to approach. Issues raised have been addressed appropriately.” Mr Stevens followed robust procedures to ensure that he had a well-trained and competent staff to care for those people living at the home. There were quality assurance and quality monitoring systems in place. The home took steps to review its performance regularly and residents’ views were sought and suggestions put forward were acted upon. Recent feedback from residents and visitors to the home was very positive and highlighted the improvements made to the service. The Registered Manager and residents spoken with confirmed that residents either deal with their own finances or have a representative to do so. The home will hold a small amount of money for residents if they so wish. Records showed us that staff had received recent training in fire safety and manual handling updates. Substances hazardous to health were seen to be stored securely. Records showed that equipment had been serviced regularly. The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 21 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 X X 3 X X 3 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 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 22 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. 2. Refer to Standard OP7 OP9 Good Practice Recommendations Daily records should reflect the wellbeing of the resident. There should be a clear audit trail for all medications coming into and leaving the home. The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 The Riseborough Care Home DS0000068327.V372772.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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