CARE HOMES FOR OLDER PEOPLE
Red Court Nursing Home 27 Stanhope Road Croydon Surrey CR0 5NS Lead Inspector
Alison Ford Unannounced 9th August 2005 10:45 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. Red Court Nursing Home G53-G53 s19040 red courtUI v198416 020805 stage 0.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Red Court Nursing Home Address 27 Stanhope Road, Croydon, Surrey, CR0 5NS 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) 020 8681 2359 020 8680 3938 BUPA Care Homes (BNH) Limited Miss Palace Chivero Care Home 35 Category(ies) of OP Old Age (35) registration, with number of places TI(E) Terminally Ill Red Court Nursing Home G53-G53 s19040 red courtUI v198416 020805 stage 0.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 18 February 2005 Brief Description of the Service: Red Court is a care home owned by BUPA and registered with The Commission for Social Care Inspection, to provide nursing care for up to thirty-five older people. The home is situated near to the centre of Croydon and is an extended house which provides accomodation over three floors.Two lifts ensure acessibilty throughout the home. All the bedrooms are single occupancy and have been fitted with hand basins and almost half of them have en-suite facilities. There are two dining rooms, a main lounge, two smaller seating areas and an activities room. The home is surrounded by exceptionally well maintained gardens in the front and an orchard to the rear of the property. The home is attractive and well presented and maintained and there are off street parking facilities to the front of the building. Red Court Nursing Home G53-G53 s19040 red courtUI v198416 020805 stage 0.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the homes first inspection for the year 2005/2006 and was unannounced. Previous inspections have always found a well maintained home offering a good quality service and this was confirmed at this visit. Any requirements are always complied with promptly and the comment cards, which had been received by The Commission, reflected the satisfaction of residents and their relatives. The visit took place over three and a half hours during the day and included a partial tour of the premises, the assessment of, a sample of care plans, staff files and training schedules. The records detailing complaints and compliments and accidents were also viewed and the manager conducted a fire drill, during the visit.Ten residents and three relatives who were visiting were spoken to and the lunchtime meal was served during the visit. The Registered Manager has been in post for some time and staff turnover within the home is low. The Commission has not received any complaints about this service since the last inspection and no extra visits have been necessary. What the service does well:
This home offers an exceptionally well-maintained environment with particularly attractive gardens. There is both adequate communal and private space so that visitors can be entertained in private or in one of the lounges. Comments from residents “that you couldn’t go wrong here” “ how happy they were “ and “how much the lovely gardens were enjoyed” reflected their satisfaction with the home and relatives also expressed their satisfaction with staff members who were “patient and caring”. Comprehensive assessments, prior to admission, ensure that placements meet the needs of the residents and these form the basis for care plans, which are subject to regular review so that they reflect current needs. Other members of the multidisciplinary healthcare team contribute to residents care as necessary and there is sufficient equipment in use to ensure their safety. Accidents to residents are monitored and appropriate interventions are used where needed. A pharmacist visit also occurred on the day of the inspection and no problems were highlighted. Activities are varied and tailored to suit the needs of the residents and include trips out and visiting entertainers. Regular meetings offer them the opportunity to influence the services that are being provided.
Red Court Nursing Home G53-G53 s19040 red courtUI v198416 020805 stage 0.doc Version 1.40 Page 6 Robust recruitment practices and an emphasis on staff training ensure that residents feel confident that they are being cared for by people who have the necessary qualifications and skills to do so. 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. Red Court Nursing Home G53-G53 s19040 red courtUI v198416 020805 stage 0.doc Version 1.40 Page 7 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 Red Court Nursing Home G53-G53 s19040 red courtUI v198416 020805 stage 0.doc Version 1.40 Page 8 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) 3,6 The pre - admission assessment undertaken with potential residents is comprehensive so that they can be sure that the home will suit their needs and any risk of the placement being unsuitable is minimised. This home does not offer intermediate care. EVIDENCE: In the sample of care plans that were assessed there was clear evidence that a comprehensive pre admission assessment is undertaken with potential residents, prior to their moving into the home. This assessment covers both physical and psychosocial needs and then forms the basis for subsequent care planning. It also includes details of their previous life to enable staff to gain an insight into the resident’s current needs and behaviour patterns. Red Court Nursing Home G53-G53 s19040 red courtUI v198416 020805 stage 0.doc Version 1.40 Page 9 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) 7,8,10 All residents have an individual care plan, which ensures that the care that they receive meets their assessed needs and that staff are aware of the appropriate action to be taken. Residents are confident that they will be treated with respect, which encourages them to retain their individuality and dignity. EVIDENCE: Each resident has an individual plan of care and five of these were examined during the inspection. Each of them contained a considerable amount of information including risk assessments, manual-handling protocols, and monitoring of risks, which could lead to the incidence of pressure sores. Staff complete daily entries of the care that has been given and there was evidence that the plans are regularly reviewed. There were entries in the plans, which illustrated that the GP, dentists, chiropodists, opticians and tissue viability nurse make visits, and equipment was seen in use throughout the home that is designed to minimise the risk of pressure sores. The accident book was seen, one resident at risk of falling had now got a sensor pad in use on his floor so that staff were alerted when he got up.
Red Court Nursing Home G53-G53 s19040 red courtUI v198416 020805 stage 0.doc Version 1.40 Page 10 Staff were observed treating residents with sensitivity and respect throughout the visit and residents confirmed all personal care is delivered with due regard for their privacy. Red Court Nursing Home G53-G53 s19040 red courtUI v198416 020805 stage 0.doc Version 1.40 Page 11 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 The activities within the home are tailored to ensure that they meet residents needs and visitors are always welcome so that links with friends and families can be maintained and encouraged. A nutritious appealing and wholesome diet helps to add variety to residents lives and they are able to comment on aspects of the home so that they can influence its running. EVIDENCE: The range of activities on offer in the home has increased since the last inspection and the appointment of a new activities organiser. Outside entertainers provide amusement for both residents and their relatives and photographs of these events are on the walls. There have been more outings using the Dial-a –Ride service and it is intended to display a stock of birthday cards and toiletries so that residents can independently purchase items themselves rather than having to rely on their keyworker. There has also been an increase in art sessions the results of which are displayed. Visitors are always welcome and several were in the home on the day of the inspection both sitting with their relatives in the lounge and enjoying the attractive gardens. The lunchtime meal was observed and was well presented and looked appetising. All those spoken to agreed that the food was varied and enjoyable and appropriate records of the food provided were seen. Regular meetings are held, every three months, at which residents can comment on the running of the home.
Red Court Nursing Home G53-G53 s19040 red courtUI v198416 020805 stage 0.doc Version 1.40 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, An appropriate complaints procedure, a copy of which is given to residents as a part of The Service User Guide, and regular meetings ensures that residents can be confident that their complaints will be taken seriously and acted upon. EVIDENCE: There is a complaints procedure in place and residents are given a copy in their Service User Guide. The complaints book was seen and there had not been any entries since the last inspection. The Commission had received none during this period either. Compliments are also recorded and there had been seven of these made since the last visit. Red Court Nursing Home G53-G53 s19040 red courtUI v198416 020805 stage 0.doc Version 1.40 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, This home offers an exceptionally well-presented and maintained environment, which meets the needs of its residents and allows them to live in a comfortable homely atmosphere. EVIDENCE: The home is very well maintained both internally and externally and attractively furnished and decorated. There is an ongoing programme of redecoration and residents have been encouraged to personalise their rooms. All areas of the home were scrupulously clean at this inspection and there was no evidence of any malodour. New gardeners have recently been appointed and the gardens are especially attractive .The residents have asked for a “sensory garden “ and an area has been planted with shrubs and plants which smell and feel particularly pleasant and the home is currently competing in the “Croydon in Bloom” scheme. Red Court Nursing Home G53-G53 s19040 red courtUI v198416 020805 stage 0.doc Version 1.40 Page 14 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 Staffing numbers comply with previously set levels and training is given a high priority, ensuring that residents can be confident that they are being cared for by staff with appropriate skills and qualifications and the homes robust recruitment procedures help to safeguard them. EVIDENCE: The off duty rotas were seen and indicated that, in line with previously set levels, there are always sufficient numbers of staff on duty to meet the needs of the residents. Eighty –five to ninety percent of care staff are now qualified to at least NVQ level 2 and four have level 3. A TOPSS training manual was seen which forms part of the induction programme for new staff and contributes towards their qualifications. Training for all staff is a high priority in this home and the schedules were seen. In addition a “ customer focus” scheme is in place called Personal Best. This is aimed at individualising the care that is given in the home. Completion results in the award of a badge. Staff files of five members of staff were seen and were all in order. Evidence of POVA clearance was in the files even where Criminal Records Bureau clearance was still awaited and work permits had been obtained where necessary. Red Court Nursing Home G53-G53 s19040 red courtUI v198416 020805 stage 0.doc Version 1.40 Page 15 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) EVIDENCE: Red Court Nursing Home G53-G53 s19040 red courtUI v198416 020805 stage 0.doc Version 1.40 Page 16 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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2
COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x x Red Court Nursing Home G53-G53 s19040 red courtUI v198416 020805 stage 0.doc Version 1.40 Page 17 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 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. Refer to Standard Good Practice Recommendations Red Court Nursing Home G53-G53 s19040 red courtUI v198416 020805 stage 0.doc Version 1.40 Page 18 Commission for Social Care Inspection Croydon, Kingston & Sutton Office 8th Floor, Grosvenor House 125 High Street,Croydon CR0 9XP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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