CARE HOMES FOR OLDER PEOPLE
Red House 93 Sheffield Road Chesterfield Derbyshire S41 7JH Lead Inspector
Rose Veale Unannounced Inspection 10th November 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Red House DS0000035768.V263207.R01.S.doc Version 5.0 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. Red House DS0000035768.V263207.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Red House Address 93 Sheffield Road Chesterfield Derbyshire S41 7JH 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) 01246 347520 01246 347522 louise.jardine@derbyshire.gov.uk Derbyshire County Council Mrs Louise Mary Jardine Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Red House DS0000035768.V263207.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 1 place for (DE) for one named person, (identified in the proposal notice), for as long as they are accommodated at the home. 21st April 2005 Date of last inspection Brief Description of the Service: Red House is situated on one of the main roads into Chesterfield, on a bus route and near to the town centre. The home is well set back from the road in secluded grounds. Red House is owned by Derbyshire County Council and provides personal care and accommodation for 20 older people. The home provides 15 long term care places, 3 respite or short term care places, and 2 places for assessment. Residents are accommodated on two floors. Red House DS0000035768.V263207.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced. There were 17 residents accommodated in the home on the day of the inspection, including 4 residents for short term care. Residents and staff were spoken with during the inspection. Records were examined, including care records, records of residents’ personal money, staff personal and training records, and the complaints book. The deputy manager was available and helpful throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better:
The activities coordinator should be employed for more hours to provide a better service for residents. Work to improve the building and grounds had not been carried out as originally scheduled. This work includes substantial improvements to the bathrooms in the home which would upgrade the facilities and improve the service offered to residents. The planned work to the grounds of the home would allow all residents to safely access and enjoy the gardens. Staff records did not contain all the information necessary to ensure residents were safeguarded. Red House DS0000035768.V263207.R01.S.doc Version 5.0 Page 6 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 House DS0000035768.V263207.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Red House DS0000035768.V263207.R01.S.doc Version 5.0 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 the following standard(s): EVIDENCE: These standards were not assessed at this inspection. Of the key standards, Standard 3 was assessed and met at the last inspection and Standard 6 did not apply to this service. As part of the inspection, care records were examined. It was seen that assessment information was comprehensive and detailed, as at the previous inspection. Red House DS0000035768.V263207.R01.S.doc Version 5.0 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 the following standard(s): 11 Staff had the experience and training to ensure that residents were well supported at the time of death. EVIDENCE: The key standards 7, 8, 9, and 10 were all assessed and met at the last inspection. Care records were checked and it was seen that care plans were well-written, detailed and regularly reviewed, as they were at the previous inspection. Care records included details of residents’ wishes at the time of death. Some staff had completed training about bereavement and other staff were waiting to do this training. Most of the staff at the home had worked there for 3 years or more and so had experience in caring for residents during their final days and in supporting relatives following the death of a resident. Red House DS0000035768.V263207.R01.S.doc Version 5.0 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 the following standard(s): 12 The home provided a good range of activities to meet the preferences and social needs of residents. EVIDENCE: All of these standards were assessed and met at the previous inspection. Since the last inspection, an activities coordinator had been appointed for 6 hours per week. The activities coordinator worked on one day per week and organised two sessions of activities for residents during the day. Activities included quizzes, crafts, discussion, and games. The activities coordinator kept detailed records of activities carried out with the response and feedback from residents. The activities coordinator was enthusiastic about the role and had lots of ideas of how to expand the activities programme, limited only by the number of hours allowed. Residents clearly enjoyed the activities and were positive about the activities coordinator. Red House DS0000035768.V263207.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 16 Residents rights were promoted and protected by the robust complaints procedure in the home. EVIDENCE: The complaints procedure and complaints book were seen. The complaints procedure contained all the information required and was available in the main entrance area of the home. Complaints made had been promptly dealt with and the action taken and outcome recorded. Residents spoken with had not made any formal complaints, but were aware that there was a complaints procedure. Residents said they would be able to complain directly to staff if necessary. Red House DS0000035768.V263207.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 19 The home was suitable for its stated purpose and provided a comfortable, homely environment for residents. However, the continued delay of the improvements to the home was adversely affecting the service and facilities offered to residents. EVIDENCE: There were alterations planned to the home which had been due to commence in August or September 2005. However, this work had been delayed and no alterations had been carried out. The work included improvements to make the garden and patio areas fully accessible to residents. Two residents spoken with said they would like to be able to make more use of the garden. It was a requirement at previous inspections that staff must have training in infection control. This had been arranged and most of the staff had undertaken the training. The training had been sourced and organised on the initiative of senior staff. Red House DS0000035768.V263207.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 and 30 The recruitment procedures in place and the priority given to staff training ensured that residents were protected and staff were well supported. EVIDENCE: Staff records were examined. The records contained the copies of Criminal Record Bureau disclosures, proof of identification, a recent photograph, and the terms and conditions of employment. The application forms and references were not kept in the home, but were kept centrally by the providers. One record did not have a photograph. The records were well organised and securely stored. Staff training records were seen and staff training was discussed with the deputy manager responsible for organising and recording training. All new staff had completed induction training. Most of the care staff had achieved NVQ in care. Infection control training had recently been carried out as required at the last inspection and this requirement had therefore been met. Red House DS0000035768.V263207.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 Residents were safeguarded by the systems in place to look after their personal money. EVIDENCE: The records of residents’ personal money held by the home were examined. The records were well kept and the money was securely stored in the home. The records included two signatures for all transactions, receipts kept, and a monthly audit check by the manager. One resident spoken with was pleased with the system as there was ‘no need to worry’ about having money for items such as toiletries and hairdressing. Residents who wished the home to look after their personal money signed an agreement on admission to the home. It was a requirement at the last inspection that the risks of Legionella had been identified and that all necessary steps to address the risks had been implemented. Records were seen of the checks and maintenance carried out to the water system. The requirement had therefore been met.
Red House DS0000035768.V263207.R01.S.doc Version 5.0 Page 15 Red House DS0000035768.V263207.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Red House DS0000035768.V263207.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? YES 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 OP19 Regulation 13(4)a) 23(2)a)o) Requirement The registered manager must ensure that the planned improvements to the home are carried out to the agreed schedule. Original timescale 31/10/05 The records of all staff employed at the home must include all the items detailed in Schedules 2 and 4. Timescale for action 31/03/06 2. OP29 19 31/03/06 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 OP12 Good Practice Recommendations The hours of the activities coordinator should be increased to improve the service offered to residents. Red House DS0000035768.V263207.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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