Inspection on 19/07/09 for Red Gables

This inspection was carried out on 19th July 2009.

CQC found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Red Gables 17/03/10

Red Gables 08/03/10

Red Gables 04/12/09

Red Gables 23/09/09

Red Gables 11/08/09

Red Gables 15/06/09

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Random inspection report Care homes for older people Name: Address: Red Gables 59 Killerton Road Bude Cornwall EX23 8EU one star adequate service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Helen Tworkowski Date: 1 9 0 7 2 0 0 9 Information about the care home Name of care home: Address: Red Gables 59 Killerton Road Bude Cornwall EX23 8EU 01288355250 Telephone number: Fax number: Email address: Provider web address: leedifford@btconnect.com Name of registered provider(s): Name of registered manager (if applicable) Ladybrook Care Homes Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 32 Number of places (if applicable): Under 65 Over 65 32 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who may be accommodated is 32. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category:- Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Red Gables is a large detached house, standing in its own grounds, near the centre of Bude. It provides accommodation for 32 elderly people on two floors. A shaft lift and staircase connect the two floors. The majority of the bedrooms have ensuite facilities. There are a number of communal areas, including a lounge, a conservatory, and a Care Homes for Older People Page 2 of 14 Brief description of the care home dining room. There are seating areas outside the home, and a patio area. The home is within walking distance of the shops for anyone who is reasonably fit. The current fee scal is (Correct at time of report) £308.00 to £400.00. This does not include hairdressing, chiropody, dental work and opticians. Some toiletries must also be privately purchased. Care Homes for Older People Page 3 of 14 What we found: This inspection was carried out by, two inspectors, on Sunday, 19 th July 2009, between 5.30 p.m. and 9.10 p.m. This inspection was carried out as a result of concerns that been raised regarding the care of two individuals who used to live the home, and because of concerns that that there were insufficient staff to meet the needs of people at Red Gables. On arrival at Red Gables at 5.30 p.m. we found that there were two care staff on duty. We were told by the staff that this was not sufficient and that the people who live at the home are not receiving the care they need. We asked staff if the people who ran the home were aware of the concerns staff had about the low levels of staffing. We were told that they were. Staff named four people who needed two people to help them transfer, for example from bed to commode. We saw that staff were also required to administer medication, serve and clear up after tea, make drinks and do any laundry. We were told that there were 27 or 28 people at Red Gables, although three were currently in hospital. We noted that when we arrived at the home there were six people downstairs in the lounge. Although, two of the individuals were on their way to their rooms. Soon after the start of the inspection everyone was in their bedroom. We were told that tea is usually between 4.30 p.m. and 5.30 p.m. As part of this visit we looked around the home, and spoke with nearly every person in the home. Some of the people were watching television, however many of the people who were more frail or confused were in bed or ready for bed. We were surprised to see so many of the people who live at Red Gables in their rooms, so early in the evening. The people we spoke with generally spoke well of staff. One person said that the staff were very obliging and that staff were kind and considerate. However, other people told us that the home was very short of staff, and one person told us that some of the staff shout. We found that the house was generally clean and in good order, and that only one of the bedrooms had an unpleasant odour. We looked at records that would show us how many staff are on duty. We found that at times only two staff were rostered to work, and on one occasion, the rota indicated that there had been only one staff rostered. We also looked at a sheet for staff to record their hours, so that they would be accurately paid. Only the most recent sheet was available covering the 18 th and 19 th July 09. This sheet showed that on the 18 th July 09, there had again been only two staff on duty between 6 p.m. and 10 p.m. The sheet also showed that there had been only three care staff on duty between 8 a.m. and 2 p.m. on 19 th July 09, and this then went down to two care staff after 2 p.m. Staff explained that they were paid a higher rate when there are only three care staff on duty, when there should be four, or when there are only two care staff on duty when there should be three. We were told that a cook had worked on both Saturday and Sunday to cook lunch and prepare the tea. Sunday lunch was a roast dinner, tea was cheese scone and banana. One of the residents told us that on the whole the meals were very good, she said that she often save cake from tea time to eat later in the evening when she was hungry. We also looked at documents related to two people who used to live at the home, and have taken these records for further consideration. Care Homes for Older People Page 4 of 14 What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 14 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 1 4 The Statement of Purpose must contain all the information that is required by regulation, including the number and sizes of rooms. A copy of this document must be provided to the Commission. The Commission must know what services and facilities a home provides, and any changes. 01/08/2009 2 3 14 Comprehensive pre 01/09/2009 admission assessments must be completed on each individual prior to moving to the home. This is to ensure that the service is able to meet the persons needs. 3 7 12 The arrangements, including 15/08/2009 space and equipment, for helping people to move or transfer must be reviewed. People must be safe from unnecessary injury caused by poor moving and handling practices. 4 7 15 People who live at Red Gables must have detailed care plans, based on 15/08/2009 Care Homes for Older People Page 6 of 14 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action comprehensive assessments. These documents must be developed and agreed with the individuals or their representatives. Staff need to know what help they are to provide. Written records help ensure that care is consistent. 5 7 13 Risk assessments must be comprehensive (covering falls, tissue viability, nutrition, self medication) and reviewed regularly. Risks should be managed positively to help keep people safe and to lead the life they choose. 6 8 15 Conditions such as diabetes must be identified in care plans, and their must be detailed accounts of how such conditions are to be managed. People need to know that their health care needs will be addressed. 7 9 13 Where people choose to self medicate, a risk assessment must be carried out to ensure that they recieve the right support and have the correct facilities People need to be supported to safely manage their own medication, where ever possible. Care Homes for Older People Page 7 of 14 15/08/2009 15/08/2009 15/08/2009 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 8 9 19 Staff must be appropriately 15/09/2009 trained if they are to carry out invasive procedures. This training must be done by someone who is competent and is authorized in this area. Staff must be competent, so as to avoid harming people. 9 9 13 The controlled drugs cupboard must comply with current standards and be fitted with appropriate bolts to the wall. Medication must be kept safe. 15/08/2009 10 9 13 Medication must only be 15/08/2009 given to the person for whom it is prescribed. It is unsafe for care staff to give people medication that they are not prescribed and which does not belong to them. 11 12 6 People must be offered the opportunity to engage in a range of activities that meet their needs. Keeping active and involved helps maintain good physical and mental health. 15/09/2009 12 15 16 People who need a soft diet must be offered food that is well presented and appealing. 15/08/2009 Care Homes for Older People Page 8 of 14 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Pureeing a whole meal, means that the food is unappetizing. 13 15 13 Staff must be appropriately trained this should include dealing with choking and have a food hygiene certificate if preparing food. People need to be safe from unnecessary harm. 14 16 22 The Registered Provider must 15/08/2009 provide the Commission with a statement of the complaints made during the preceding 12 months (or from the time of registration), and the actions that were taken in response. The Commission needs to be confident that complaints have been properly managed. 15 16 17 The Registerd Provider must 15/08/2009 ensure that information relating to complaints is kept in the home and available for inspection. The Commission needs to be able to check at inspection that complaints are being properly managed. 16 18 12 The Registered Provider must 15/08/2009 ensure that all allegations of abuse are referred to the Safeguarding Process. People must be protected Care Homes for Older People Page 9 of 14 01/09/2009 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action from abuse. 17 22 16 The Registered Provider must 15/08/2009 review the bedroom accommodation, to ensure that each person has sufficient space so that they can move or be assisted safely. Insufficient space can lead to people being moved incorrectly or equipment not being used. 18 27 18 The staffing levels must be 15/08/2009 reviewed to ensure that staff have sufficient time to carryout their duties. Lack of staff can lead to a poor quality of service for people in Red Gables. 19 29 19 Appropriate recruitment 15/08/2009 checks must be made to ensure that suitable staff are recruited. This must including two references and a POVA check prior to starting work. Staff must be suited to working with vulnerable people. 20 31 12 The home must be properly managed, ensuring that where issues have been identified, that action is taken to put things right. The Manager has a central role in improving the service. Care Homes for Older People Page 10 of 14 15/08/2009 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 21 35 13 Any money held on behalf of 15/08/2009 people who live at Red Gables, must be kept safe, appropriately managed and properly accounted for. This includes keeping receipts and not loaning money. The people who live at Red Gables need to know that their money is kept safe and available to them. 22 38 13 Risk Assessments, including a fire risk assessment and legionella risk assessment must be completed and any checks or actions implemented. People must be protected from unnecessary risk of harm. 15/08/2009 Care Homes for Older People Page 11 of 14 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 27 12 There must be sufficient staff 26/07/2009 on duty to meet the needs of the people who live at Red Gables. There must be a minimum of 3 people on duty between 8 a.m. and 10.00 p.m. Insufficient staff to meet needs could lead to an increase risk of harm or neglect. (This requirement was made on 19/7/09 to have immediate effect). Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 15 15 The time of the meals must be reviewed so that they give people the opportunity to eat and drink through out the day and evening. Large gaps between meals or drinks can adversely affect peoples health and well being. 15/08/2009 Care Homes for Older People Page 12 of 14 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 13 of 14 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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