Inspection on 16/05/05 for Mother Redcaps Nursing Home

This inspection was carried out on 16th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Mother Redcaps Nursing Home 27/10/09

Mother Redcaps Nursing Home 29/06/08

Mother Redcaps Nursing Home 24/05/07

Mother Redcaps Nursing Home 04/12/06

Mother Redcaps Nursing Home 19/05/06

Mother Redcaps Nursing Home 21/12/05

Mother Redcaps Nursing Home 21/10/04

Mother Redcaps Nursing Home 19/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Mother Redcaps Nursing Home Lincoln Drive Egremont Parade Wallasey CH44 2AA Lead Inspector Miss Julie E King Unannounced 16 May 2005 13:00hrs 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 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. Mother Redcaps Nursing Home Inspection report OP.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Mother Redcaps Address Lincoln Drive Egremont Parade Wallasey CH44 2AA 0151 639 5886 0151 630 2295 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) CRH with Nursing 51 Category(ies) of PD - 18-64 yrs Physical Disabilities - 2(within registration, with number overall total) of places OP - over 65 yrs - 51 Mother Redcaps Nursing Home Inspection report OP.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: A maximum of 51 older persons may be accommodated of whom no more than 2 adults shall be in the category PD and 1 named adult under 65 years of age Date of last inspection 21 October 2004 Brief Description of the Service: This care home is a three-storey purpose built nursing home, situated on Egremont Promenade overlooking the river Mersey, and offers nursing care for 51 older persons.A lounge/dining room is provided on each floor with televisions, videos, piano, and music centres available. The home is double glazed throughout and ramp access is available at the front entrance. A lift serves all floors.All accommodation offered is in single rooms and the majority have the benefit of en-suite facilities.A selection of bathrooms, showers and toilets are provided on each floor and assisted bathing facilities are available.The small front and side gardens are well maintained and car parking is provided at the front of the building. Mother Redcaps Nursing Home Inspection report OP.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory unannounced inspection took place over five hours. A full tour of the premises, including the kitchen and laundry took place. A range of records such as care plans, staff personnel files, policies & procedures and medication charts were examined. A number of staff on duty, and some patients were spoken to during the course of this inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Mother Redcaps Nursing Home Inspection report OP.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Mother Redcaps Nursing Home F52_F02_s20940_MotherRedcaps_v227017_160505_Stage 4.doc Version 1.30 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 & 4 The home’s Statement of Purpose and Service User Guide is inadequate and out of date, and does not provide sufficient information for prospective patients with details about the services the home provides. EVIDENCE: Examination of the Statement of Purpose and Service User Guide evidenced that the previous owners and manager are still named on the documents, and no details of the new owner or their management arrangements were available. Neither document contains all the required items as listed in Schedule 1 and Regulation 5 of The Care Homes Regulations 2001. The last few patient’s pre-admission assessments, including a couple of respite patients, were examined. These evidenced that a holistic assessment is undertaken with the involvement of the prospective patient and their representative as wanted prior to admission to the home. There was clear evidence of multidisciplinary healthcare team involvement for those patients that need NHS or outside professional involvement. There was minimal evidence of recent, specialist training for staff for specific patient conditions. Mother Redcaps Nursing Home F52_F02_s20940_MotherRedcaps_v227017_160505_Stage 4.doc Version 1.30 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10 There is no clear or consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet patient’s needs. The medication management was compliant with the current national minimum standards. EVIDENCE: A random selection of care plans and related documentation was examined as part of the case-tracking process. The care plans seen were in the process of changing format and reviews, but did contain basic information. The plans lacked specific care needs of each patient, as identified on either pre-admission assessments or the daily reports. There was regular differences seen in the daily reports and what was identified on the care plans. This inconsistency could lead to some patient’s care needs not being fully met. NHS and other healthcare professionals are involved as needed in the care of the patients, and outpatients appointments are attended. Policies, procedures and guidance was available for the safe management and administration of medications, and on the day of this unannounced inspection, the medications were compliant with current legislation. A random medication Mother Redcaps Nursing Home F52_F02_s20940_MotherRedcaps_v227017_160505_Stage 4.doc Version 1.30 Page 9 count was found to be correct, and the Medication Administration Records (MARs) were also being completed correctly. A drugs of potential abuse and controlled drug medication count was also found to be correct. Mother Redcaps Nursing Home F52_F02_s20940_MotherRedcaps_v227017_160505_Stage 4.doc Version 1.30 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Links with the local community are good, and support and enrich patient’s social opportunities. The meals in this home are good, offering both a choice and variety, and catering for special dietary needs. EVIDENCE: The home has appointed a new activities co-ordinator for 20 hours per week, who is in process of planning a new activity programme for all interested parties. The patients are asked on admission about their interests and preferences, and information they would like to share about their lives before going into the care home. This information is the basis for planning suitable activities for the patients. Family and friend involvement in the daily lives of the patients is actively encouraged, and visitors are allowed into the home at any reasonable time. Patients informed the inspector that they are given choice in what they eat, and they enjoy the “tasty, well presented meals.” Mother Redcaps Nursing Home F52_F02_s20940_MotherRedcaps_v227017_160505_Stage 4.doc Version 1.30 Page 11 The meals served on the day of inspection looked appetising and staff were seen giving discreet assistance to those who require assistance with eating and drinking. Fresh fruit and vegetables were available, and the chef bakes cakes, pies and puddings on a daily basis. Mother Redcaps Nursing Home F52_F02_s20940_MotherRedcaps_v227017_160505_Stage 4.doc Version 1.30 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The home has a satisfactory complaints system, but the CSCI has received a number of recent complaints since the previous inspection. The home has not given staff enough training in the protection of vulnerable adults, potentially placing patients at risk. EVIDENCE: A complaints policy and procedure is displayed in the main foyer of the home, and a record is kept of any concerns or in-house complaints that are raised. The complaints procedure has contact details of the local CSCI. The patients all spoke highly of the staff team and said they “have no complaints about how I’m treated”. Some advocacy information was available if required by patients or their relatives. The care home has no up to date information on the Protection of Vulnerable adults, or evidence that this information is communicated to new employees on their induction course. On the day of the inspection there was no evidence that most of the staff in the home had undertaken training on POVA protocols. Mother Redcaps Nursing Home F52_F02_s20940_MotherRedcaps_v227017_160505_Stage 4.doc Version 1.30 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26 Since the previous inspection the standard of décor within the home has deteriorated, with no signs of improvement through maintenance or future planning. The home does not therefore, present as a homely and comfortable environment for all patients. EVIDENCE: During this unannounced inspection the inspector walked around the interior of the building, examining all communal and most patient areas. The top floor had a strong smell of urine on the main corridor and many bedrooms. The lounge carpet on the top floor was very badly stained and smelt strongly of stale urine. This carpet requires urgent replacement as deep cleaning would not be sufficient. Many of the patient’s bedrooms were also showing signs of wear and tear, and again had lowered in standard a great deal since the last inspection. Some of the rooms seen had torn wallpaper, with bits missing. Others had smelly and stained carpets and torn bedding. Damaged paintwork was also common in all areas. Mother Redcaps Nursing Home F52_F02_s20940_MotherRedcaps_v227017_160505_Stage 4.doc Version 1.30 Page 14 A lot of the extractor fans in sluices and bathrooms were not working, and the ground floor sluice also had ceiling tiles missing. One of the patient’s bedrooms had a large number of cigarette burns on the floor, and the inspector was told that there was no written plan to replace this carpet in the near future. Most bathrooms and toilets had a selection of communal use soaps, which is a high cross-infection risk to all patients. Other toiletries such as liquid soaps, shampoos and bubble bath were also seen in communal bathrooms. This practice must stop straight away as confused patients may eat or drink these products, causing a great deal of harm or even death. Mother Redcaps Nursing Home F52_F02_s20940_MotherRedcaps_v227017_160505_Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 Since the last inspection the standard of vetting and recruitment practices has declined with appropriate checks not being carried out and potentially leaving patients at risk. The staff morale is low with high levels of sickness and turnover of staff. This situation is having a detrimental impact on the standard and consistency of care offered within the home. EVIDENCE: A random selection of staff personnel files were examined including new starters. The files seen did not contain all the checks, records or documents as required. Some of the files didn’t even have CRB (Criminal Records Bureau) or POVA (Protection of Vulnerable Adults) checks. A couple of the qualified staff only had references from friends, and not their last employer as required. Some other staff files had evidence of mandatory training, but others had none, or very little specialist training. The inspector was unable to find out how many staff have got their NVQ in Care, or how many are in process of doing it at the moment. The staffing rota evidenced that the care staffing numbers have been cut from five at night to four. This was done by the new management without consultation with the CSCI, an does not reflect the dependency ratings of the Mother Redcaps Nursing Home Version 1.30 Page 16 F52_F02_s20940_MotherRedcaps_v227017_160505_Stage 4.doc patients. The night staffing numbers must be increased back to five care assistants at night straight away. The inspector was told from various sources that the new management also plan to reduce the day staff hours soon. Again, this must not happen without prior discussion with the CSCI, and must reflect the individual and collective needs and dependencies of all the patients. Mother Redcaps Nursing Home F52_F02_s20940_MotherRedcaps_v227017_160505_Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 35 & 38 The staff morale is low at this home resulting in high staff turnover and poor attendance, that in turn results in an inconsistent and unsatisfactory service. EVIDENCE: A new provider, who is not yet registered with the local CSCI office has bought the home. Since then there has been numerous changes, including a new manager (also not yet registered). There has been a high turnover of staff in recent months, with most of the night staff leaving and being replaced. Staff spoken to expressed their concerns regarding all the changes and were obviously unsettled with all the recent upheaval. The new manager has a plan for the future development of the home, and intends to address all the issues raised during this inspection. Mother Redcaps Nursing Home F52_F02_s20940_MotherRedcaps_v227017_160505_Stage 4.doc Version 1.30 Page 18 Policies and procedures are in place regarding the safekeeping of patient’s monies and valuables, and financial records were seen. Certificates for gas and electrical safety were in date and valid. The home has the advantage of having an in-house health and safety representative (the administrator), who completes environmental risk assessments, fire and moving & handling training for all staff. Mother Redcaps Nursing Home F52_F02_s20940_MotherRedcaps_v227017_160505_Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 x x x x x x 2 STAFFING Standard No Score 27 2 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x 2 2 x 3 x x 3 Mother Redcaps Nursing Home F52_F02_s20940_MotherRedcaps_v227017_160505_Stage 4.doc Version 1.30 Page 20 No Are there any outstanding requirements from the last inspection? 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. 1. Standard 1 Regulation 4 Requirement The registered person must compile a Statement of Purpose which is to include all the items as listed in Schedule 1 of The Care Homes Regulations 2001. The registered person must produce a Service User Guide that is to include all the items as listed under this regulation. The registered person must produce a care plan for each service user (patient) that must be kept relevant and updated on a regular basis. The registered person must ensure that all staff receive adequate training regarding the prevention of abuse for vulnerable adults. The registered person must ensure that the care home is in a good state of repair and reasonably decorated at all times - and must put right all the items identified in this report. The registered person must keep the care home clean and odour free at all times. The registered person must ensure that there are sufficient staff on duty at all times. Timescale for action 30 June 2005 2. 1 5 30 June 2005 30 June 2005 3. 7 15 4. 18 22 30 July 2005 5. 19 23 30 July 2005 6. 7. 26 27 16 18 30 June 2005 18 May 2005 and ongoing Page 21 Mother Redcaps Nursing Home F52_F02_s20940_MotherRedcaps_v227017_160505_Stage 4.doc Version 1.30 8. 29 19 9. 30 18 10. 32 12 11. 33 24 The registered person must obtain all the documents and records for all persons employed, and must have CRB and POVA checks for all staff prior to employment. The registered person must ensure that all staff recieve training appropriate to the work they perform The registered person must ensure that good professional relationships are established between management, staff and service users. The registered person must ensure appropriate quality assurance process are commenced with the involvement of service users and their representatives. 30 May 2005 30 June 2005 18 May 2005 and ongoing 30 June 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 7 Good Practice Recommendations It is recommended that all significant conversations between qualified staff and service users representatives are clearly recorded. Mother Redcaps Nursing Home F52_F02_s20940_MotherRedcaps_v227017_160505_Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Liverpool Area Office 3rd Floor 10 Duke Street Liverpool, L1 5AS National Enquiry Line: 0845 015 0120 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 Mother Redcaps Nursing Home F52_F02_s20940_MotherRedcaps_v227017_160505_Stage 4.doc Version 1.30 Page 23 - 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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