Inspection on 29/06/08 for Mother Redcaps Nursing Home

This inspection was carried out on 29th June 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 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 16/05/05

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 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Mother Redcaps Nursing Home Lincoln Drive Egremont Promenade Wallasey Wirral CH45 7PL Lead Inspector Janet Marshall Key Unannounced Inspection 29th June 2008 09:30 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 Mother Redcaps Nursing Home DS0000020940.V362768.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. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mother Redcaps Nursing Home Address Lincoln Drive Egremont Promenade Wallasey Wirral CH45 7PL 0151 639 5886 0151 630 1730 janetnixon56@yahoo.co.uk 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) Mary George Limited Mrs Janet S Nixon Care Home 51 Category(ies) of Dementia (12), Old age, not falling within any registration, with number other category (39), Physical disability (2) of places Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - Code N 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: 39) Physical disability - Code PD (maximum number of places: 2) Dementia - Code DE (maximum number of places: 12) The maximum number of service users who can be accommodated is: 51 Date of last inspection 24th May 2007 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. Fees range from local social service rates to £481. Mother Redcaps Nursing Home DS0000020940.V362768.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 3 star. This means the people who use this service experience excellent outcomes. This was a key inspection. The Commission considers 22 standards for Care Homes for Older People as Key Standards, which have to be inspected during a Key Inspection. All key standards for this type of service are highlighted in bold in the relevant sections of this report. The report has been put together using information gathered from a number of sources including information that the commission have received about the service since the last inspection which took place in May 2007 and details provided in the Annual Quality Assurance Assessment (AQAA). The AQAA, which is in two parts, a self-assessment and dataset, has replaced the preinspection questionnaire. The document, which was sent out to the service was completed in good detail and returned to the commission before the site visit took place. A number of surveys were given out to people as part of the inspection. Responses and comments from those that were filled in have been used to help put together this report. The inspection also involved an unannounced visit to the home (site visit). This was carried out with the help of the registered manager Mrs Janet Nixon, nurses, care staff other staff that were on duty at the time. Records that were examined, staff comments and observations made during the visit have also been used as evidence for the report. A number of residents and relatives were spoken with during the site visit and their views and opinions about the service are reflected within the report. A number of residents were case tracked. This process involved talking to residents, staff and relatives, looking at the environment and a selection of residents records such as assessments, care plans and daily notes to get an idea about peoples experiences and to find out if they are receiving the care and support that they need and which they have agreed. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 6 What the service does well: People who are thinking about moving in are given up to date information about the home and their needs are properly assessed so that they can be sure that it is the right place for them to live. Available at the home were a selection of care plans for each resident, which clearly set out how staff need to meet their assessed health, personal, and social care needs. Care plans were signed to show that they were put together with the full involvement of the resident and/or their representative. There was also evidence to show that care plans are being regularly reviewed and they are being updated when a persons needs have changed. Staff showed good knowledge and understanding of the needs of the residents, during the inspection visit they were observed talking to residents in a polite manner and treating them with respect. Residents spoken with said that staff are always polite and treat them well they made the following comments to support this: “Staff always knock on my door” “They help me with personal care they do it in a dignified way” “The staff are very considerate” “The staff always treat me well” “The staff knock on my door and are always very polite” Residents are offered a varied and healthy diet which is prepared and cooked by a qualified chef. The home had in place appropriate procedures for responding to concerns complaints and for ensuring that residents are safe from abuse, harm or neglect. Everybody spoken with during the inspection said that they had been given information about how to make a complaint if they needed to. People were confident that their complaints would be listened to and dealt with in the correct way. The home was comfortable, well maintained and free from hazards making it a pleasant and safe place for people to live in. More than half of the staff team have achieved or are working towards a National Vocational Qualification in Care level 2 or above and they have all completed or are planning to complete training linked to the aims and objectives of the home and the needs of the residents. The home is well managed to the benefit of the residents and staff. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 7 The registered manager is well qualified and experienced to manage the home. Comments made about the managers included: “There have been massive improvements here since Janet started”. “She has brought back the pride” “It is a magnificent place” “She is understanding, listens and is easy to talk to” “Lots of things have changed for the better”. “Janet is approachable, trustworthy and I feel well supported”. 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. The summary of this inspection report can be made available in other formats on request. Mother Redcaps Nursing Home DS0000020940.V362768.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 Mother Redcaps Nursing Home DS0000020940.V362768.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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 1&3 Before deciding to move in people are given detailed information about the home, their needs are thoroughly assessed and they are offered visits to the home so that they can be sure it is the right place for them live. EVIDENCE: The Homes Statement of Purpose and Service User Guide have been updated since the last inspection. Both documents, which were examined, included all the information required by regulation. They were available in clear print and well presented. Information provided in the AQAA and discussion with the manager confirmed that the documents are given to prospective residents and their relatives. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 10 The AQAA showed that thirteen residents have been admitted to the home in the last 12-mths. The manager confirmed that pre-admission assessments have been carried out for all newly admitted residents. Pre-admission assessments carried out for three recently admitted residents were examined in detail. Assessments included those carried out by the manager of the home and others carried out by Social Workers. All assessments were detailed and covered all aspects of the persons live including, sight, hearing social contacts, religion, previous lifestyles, medical history, mobility, personal care skills, sleep, rest, diet, living, working and recreational interests. Each of the files examined also included an assessment checklist. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 7, 8, 9 & 10 Residents health and personal care is well supported and monitored and they are treated with dignity and respect. EVIDENCE: All residents had a care file which was kept securely in the office. Three residents care files were looked at in detail as part of the case tracking process. Care files contained a selection of care plans. All care plans looked at were detailed and covered each persons care need requirements which were highlighted in their pre- admission assessments. Care plans provided staff with clear information and instructions about how best to care and support the person in a way that they prefer and which promotes their privacy, dignity and independence. The plans looked at covered such things as health and personal care, eating and drinking, sleeping, mobility, sexuality, elimination, communication and mobility. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 12 The plans also highlighted where a risk assessment is needed. Risk assessments have been carried out for tasks and activities which have been assessed as posing a risk to the resident and/or the member of staff helping them. Like the care plans, risk assessments also provided staff with information and clear instructions about the action they need to take to minimise any risk to the resident or themselves. Risk assessments are important because they help people to live independently in a safe way. Staff spoken with showed a good understanding of care plans and the importance of them. The following comments made by staff supported this: “Care plans tell us about the care that people need” “They tell us if things have changed” “They tell us about peoples needs” Records showed that all parts of each persons care plan and risk assessments have been reviewed and updated at least once a month. Residents and their family/representative are fully involved in this process ensuring that they agree to the care they are to receive. Records which were looked at showed that peoples health is well supported and monitored. There was evidence to show that people see their doctor when they need to or if they ask and they are supported to attend other health care appointments such as dentists, chiropodists and opticians. Residents are also seen by other specialists such as dieticians, speech therapists and mental health professionals. Details of all appointments, treatments and nursing care provided were recorded in good detail. Qualified nurses that work at the home attend to such things as dressing wounds and giving injections. The nursing care they provide people with was also recorded in good detail. Were appropriate peoples weight, elimination and water low is closely monitored and recorded as a way of making sure they stay well. Information provided in the AQAA, discussion with staff and examination of records showed that staff have received or are planning to attend training which helps them to understand and manage certain healthcare conditions and behaviours which residents have. Training in topics such as, diabetes, limb care, Parkinson’s disease, dementia care and mental health awareness have been attended by staff. Throughout the inspection staff were seen treating resident politely and in a respectful way. They sat closely to them when talking and were gentle and patient in their approach. Staff gave the following examples of the things they do to ensure peoples privacy and dignity: “Always shut doors and windows when helping with personal care” “Make sure the person is warm” “Always knock before entering a residents bedroom” Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 13 Residents spoken with said: “Staff always knock on my door” “They help me with personal care they do it in a dignified way” “The staff are very considerate” “The staff always treat me well” “The staff knock on my door and are always very polite” Residents relatives spoken with said: “The staff look after mum very well” “The staff are very caring and gentle when helping mum” “Mum is always clean and tidy” “I always see staff sitting and talking politely to residents” A healthcare profession visiting the home at the time of the inspection said: “The staff are excellent I have only ever seen them treating the residents well” Letters to the manager and staff recently received from residents relatives included the following: ‘I thank you for all your care, it helps a great deal to see such patience and loving kindness’. ‘Your warmth and respect and the support and consideration have been invaluable’. ‘With thanks for all your love and care’. The AQAA told us that the home has a number of policies and procedures and codes of conduct for the safe handling, administration and recording of medication. Copies of the polices, procedures and codes of conduct were on display in the room where medication is stored. Records showed that medication is administered only by staff that have received the required training. Medication which was looked at was stored correctly and medication administration records (MARs) which were checked were well kept. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 12, 13, 14 & 15 Residents are supported and encouraged to live active and healthy lives. EVIDENCE: An activities co-ordinator has been employed at the home since the last inspection. She was working at the home at the time of the inspection when she was seen supporting the residents in a variety of activities including painting, pampering sessions and board games. Discussion took place with the activities co-ordinator who said the activities have improved the resident’s lives. She said all residents are offered to take part in activities and she sits and talks to those that do want to join in. All activities that residents take part in or are offered were recorded. An activity programme was on display at the home it detailed planned activities for the forthcoming month including the time and date it was taking place. Activities included card games, pampering sessions, painting, music and dancing and reminiscence therapy. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 15 A survey filled in by residents showed that there are usually activities arranged by the home they can take part in. “Christmas is always special” was a comment included in one survey. A visitor’s book, which was seen at the home, showed that residents receive regular visits from friends and family members. Visitors were seen coming and going at intervals throughout the inspection visit. They were welcomed by the manager and staff and offered refreshments. Residents spent time with their visitors in the privacy of their own rooms, the lounge areas and outside in the garden. Discussion took place with a number of visitors, all of them said that they are always made to feel welcome at the home by both the manager and staff. One relative said, “I can come and see mum at any time”. During the inspection visit residents were seen making choices for themselves, others were seen being encouraged by staff to make choices. Residents spoken with confirmed that they choose what clothes they were each day and decide what time they get up and go to bed. Discussion with the chef and examination of menus showed that residents are offered a good variety of food which is nutritious and healthy. The chef who is qualified was very knowledgeable about the dietary needs of the residents. Surveys filled in by residents included the following comments: ‘Meals are of a high standard and various options are available’. ‘A great variety, well prepared and presented’. Serving of the lunchtime meal was observed. Tables were attractively laid with tablecloths, mats, napkins and cutlery. Staff transported food to the three separate dining rooms using a hot trolley. Meals were served to the residents individually by staff. Staff talked to residents to explain what they were eating and to ask if they need any assistance. Staff were seen encouraging residents to eat. Staff did not rush any of the residents and took their time assisting those residents who needed help. There were a number of residents who were offered alternatives because they chose not to eat the lunch of the day. Residents appeared to be satisfied with the options they were given. Residents were served with hot and cold drinks both during and after their meal. Drinks and snacks were also offered at intervals throughout the day. The homes menu was displayed on dining tables around the home. The menu was colourful and attractively presented and in large clear prints making it easy for people to see and read. Residents and staff spoken with spoken with all said that the quality, quantity and choice of food are very good. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 16 The food stores were looked at. There was plenty of food including tinned, dried, fresh and frozen. There was plenty of milk, eggs, yogurts, butter and cheese. The chef said that shopping is bought and delivered from the local supermarkets, fruit and vegetables from a local greengrocers, and meat from a local butcher. Freezers were well stocked with such things as meat, bread and fish. The kitchen was equipped with a microwave, a food mixer and there were a variety of pots and pans. There was plenty of crockery for resident’s use, which was matching, and of good quality. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 16 & 18 Staff have received abuse training and procedures are followed at the home to ensure people are protected from neglect, harm and abuse. EVIDENCE: Information provided in the AQAA and discussion with the manager and staff showed that there have been a number of complaints made to the home in the last 12 months. A complaints log at the showed that all complaints have been appropriately recorded and investigated within 28 days. Outcomes of all complaint investigations were also available. There was a complaints procedure on display at the home. It is also available in the homes Statement of Purpose and Service User Guide. Residents and staff spoken with during the inspection all said that have the information that they need to make a complaint if they wish to and they would feel confident about making a complaint. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 18 The following results of surveys and comments made by residents, their relatives and staff supported this: People know who to speak to if are not happy People do know how to make a complaint Carers always act on what people say “The Manager is always helpful and responds to any problem we raise”. “The nursing sister is always available” “I would complain if I needed to” “Am very confident about making a complaint” “Yes, I would definitely complain if I needed to” “I am very happy with everything, but would complain if I was unhappy about something” The manager confirmed that all staff are provided with copies of the homes policies and procedures for complaints, whistle blowing and Protection of Vulnerable Adults. Since the last inspection all staff that work at the home have completed protection of vulnerable adults training provided by Wirral Social Services. The training helps staff to recognise the signs of potential abuse and how to report them appropriately. Staff spoken with described appropriately what they would do if they saw or thought a resident was being abused. A copy of Wirral’s Local Authority Protection of Vulnerable Adults policy was available at the home along with other documents which provide staff with information and guidance about what they need to do if they witnessed abuse taking place including the No Secrets Document. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 19 & 26 Many improvements made to the environment have enhanced the dignity, comfort and safety of the residents. EVIDENCE: The home is situated in a popular residential area of Wallasey, Wirral, Merseyside. A number of residents bedrooms communal lounges and gardens at the back of the building benefit from a spectacular view of the River Mersey and Liverpool’s three Graces. There is a large car park at the front of the house and well kept gardens at the back and two sides. Garden furniture is available outside so that residents and their visitors can sit out if they wish. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 20 The home had a warm and friendly atmosphere and staff and residents were very welcoming. Since the last inspection the home has undergone a lot of improvements which have enhanced the comfort and dignity of the residents. Improvements include: • • • • • • • The re-decoration of all communal areas Installation of a new bath hoist A redesigned and newly installed wet room. A new sign has been made for the EMI unit. Ornamental fencing has been erected to the front of the home. Replacement windows have been installed to six bedrooms and one fire exit door. Emergency lighting and fire alarm sounders have been replaced. The AQAA told us that an ongoing maintenance programme is in place detailing the plans for further improvements including the redecoration of residents bedrooms and the replacement of carpets and bedroom furniture. All parts of the home were clean, peasant and hygienic and there were no hazards identified at the time of the inspection. Residents spoken with said that their rooms and other parts of the home are always clean and tidy. They made the following comments: “My room is always kept clean and tidy” “The home is never dirty” “It is always clean” Surveys filled in by residents showed that the home is always fresh and clean. A full time laundry assistant is employed at the home. The laundry, which is located in the basement area, was equipped with sufficient washing and drying machines and ironing facilities. The laundry was clean and well organised. Detailed in AQAA and available at the home were a number of policies and procedures, which aim to ensure a clean and safe environment, they include infection control and disposal of soiled waste. Hand gel was available around the home for peoples use to minimise the risk of cross infection. Staff were seen appropriately using protective gloves and aprons. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 27, 28, 29 & 30 Recruitment and training of staff ensure that residents are supported by the right people. EVIDENCE: The staffing rota, which was examined as part of the inspection showed that there are a sufficient staff on duty to meet the needs of the residents. There is always qualified nurse on duty throughout the day and night. Discussion with the manager and information provided in the AQAA showed that the turn over of staff and the use of agency staff has been low since the last inspection. Four members of staff were interviewed during the inspection. General discussion also took place with a number of other staff at intervals throughout the visit. They said that there is always enough staff on duty to meet the needs of the residents. Staff interviewed showed a good understanding of their roles and responsibilities, were very knowledgeable about the needs of the residents and showed a real commitment to ensuring that they are well cared for and have a good quality of life. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 22 Residents and their relatives spoken with during the inspection visit made many positive comments about the staff, comments included: “The “The “The “The “The “The “The staff staff staff staff staff staff staff are are are are are are are marvellous”. absolutely wonderful”. really nice, they are just perfect”. excellent”. fantastic”. very understanding”. well trained they are very good at what they do”. A survey filled in by a resident included the following comment: ‘The staff are very hard working, honest and true’ Surveys filled in by residents showed that staff always listen and act on what residents say and are always available when needed. An equal opportunities policy and procedure was available at the home. The AQAA showed that the home employs people of various ages, gender and of different backgrounds. The AQAA told us that there has been a complete review of the homes recruitment and selection procedures to ensure the full protection of residents. This was also evidenced upon examination of records for three new staff that have been recruited since the last inspection. A new administration checklist is now put at the front of each staff file to show the checks which have been carried out. The records showed the required checks were carried out before the people were allowed to start work at the home. Staff files were better organised and presented making them easy to access. The AQAA showed that since the last inspection the homes induction programme has also been reviewed and re-written based on The National Training Organisation for Social Care. Records which were viewed for new staff showed that they received induction training during the first part of their employment at the home. The AQAA showed since the last inspection staff have received a good amount of training relevant to the jobs that they do. It also showed that training is high on the agenda and there is further training planned for the future in both mandatory and specialist subjects. Training is provided out side the home by varies training companies and Wirral Social Services. In house training is also provided by the manager and other staff that are qualified trainers. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 23 Records which were looked at during the inspection visit showed staff have completed training to update their knowledge and skills and the training is linked to the aims and objectives of the home and the needs of the residents. Each member of staff now has a training and development plan which is used to assess and identify their individual training needs. A training calendar showing future training planned was available at the home. The calendar included the following topics: Moving and Handling, Dementia Awareness, Diabetes, Limb care, Medication, Infection Control and Equality and Diversity. Staff spoken with said that they have completed a lot of training since the last inspection and gave the following examples, Fire Safety Health and Safety, POVA, Medication Awareness and First Aid. The AQAA and staff training records held at the home showed that more than half the staff team have achieved a National Vocational Qualification (NVQ) in care level 2 or above. NVQ training was also included in training planned for the future. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 24 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 31, 33, 35 & 38 The home is well managed to the benefit of residents, their families and staff. EVIDENCE: Janet Nixon is the registered manager of the home. Janet started work at the home in March 2007, she is a qualified nurse and has a number of other qualifications relevant to her work and many years experience of working in the field of health and social care. Previous inspections identified a number of shortfalls in relation to the management and administration of the home. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 25 Since her appointment the manager has reviewed and updated existing management systems as well as implementing new ones all which have contributed to the overall improvement of the service. There was evidence from this inspection that processes and records for care planning and reviewing, staff development and supervision, recruitment and selection of staff and systems for monitoring the quality of the service are all in place and being managed efficiently in the interests of the residents. The AQAA told us that there is an open door policy operated at the home which means people are encouraged to talk to the manager in private about any issues which they may have. This was confirmed by staff and residents who said the manager is approachable, easy to talk to and they feel confident about talking to her about both work and personal related issues. Residents and staff spoken with during the inspection were very complimentary of the manager and the way she runs the home, the following comments made during the inspection supported this: “There have been massive improvements here since Janet started”. “She has brought back the pride” “It is a magnificent place” “She is understanding, listens and is easy to talk to” “Lots of things have changed for the better”. “Janet is approachable, trustworthy and I feel well supported”. Discussion with the manager and records, which were examined, showed that the home has in place a number of quality monitoring systems, which aim to ensure that the home is run in the best interests of the residents. Satisfaction questionnaires are given out to residents and their representatives as a way of seeking people’s views about the home and the results of them are used to plan make the necessary improvement and to plan for the future. The service manages small amounts of personal money for some residents. Money and financial records which were examined were in good order and well kept. The health safety and welfare of residents are well protected this was supported by a set of policies and procedures, which were detailed in the AQAA and available at the home. All the homes policies and procedures have been reviewed and updated since the last inspection. Information provided in the AQAA and examination of a selection of health and safety records showed that the required health and safety checks have been carried out on the environment at the required intervals, for example fire system checks, gas and electricity checks and environmental risk assessments. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 26 Staff and residents spoken with confirmed that they hear the fire alarm system regularly being tested. Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 4 X X 4 Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 28 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. Refer to Standard Good Practice Recommendations Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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 Mother Redcaps Nursing Home DS0000020940.V362768.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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