Inspection on 13/08/07 for Red House

This inspection was carried out on 13th August 2007.

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

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

Other inspections for this house

Red House 19/04/06

Red House 10/11/05

Red House 21/04/05

Red House 11/10/04

Red House 28/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Red House 93 Sheffield Road Chesterfield Derbyshire S41 7JH Lead Inspector Denise Bate Key Unannounced Inspection 13th August 2007 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 Red House DS0000035768.V341134.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. Red House DS0000035768.V341134.R01.S.doc Version 5.2 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.woodward@derbyshire.gov.uk www.derbyshire.gov.uk Derbyshire County Council Mrs Louise Mary Woodward Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th April 2006 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. Fees are £381.84 per week for permanent residents, but a range of prices for short term care residents. Additional charges, e.g. hairdressing, chiropody, are clearly identified in the home’s Statement of Purpose and Service User Guide. Copies of inspection reports are available in the foyer. Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over five and a half hours. During the inspection six residents, one relative, and two staff members were spoken with. A cross section of residents were spoken with, including long stay and short term care residents. The manager and a deputy manager were present during the inspection and provided assistance and information. Prior to the inspection a number of sources of information were looked at including the home’s service record and previous inspection reports. . An Annual Quality Assurance Assessment (AQAA) was completed by the manager prior to the inspection and information provided has been used in the preparation and presentation of this report. Nine residents completed surveys (some with help from relatives), which provided additional information and comments on the home, which are also included in this report. A number of records were examined on the day of inspection, including care planning documentation, minutes of meetings, regulation 26 visit records, staff files, accident book and medication records. Three residents were case tracked and care planning documentation and files for other residents were seen. A tour of the building took place and the grounds were seen. What the service does well: Red House provides a comfortable, homely, and relaxed environment for residents. Residents and relatives spoken with made positive comments about the home and staff; ‘the staff treat you like one big family’ ‘the staff are good’; ‘you couldn’t find a better place’, ‘the staff are very cheerful’, ‘Red House is a lovely place’. Communal areas of the home are comfortable and provide a range of areas for residents to use. The home was found to be well maintained and clean throughout. The food was said to be ‘very good’ and the quality was praised. Staff spoken with were experienced, knowledgeable, and committed to the welfare of residents. There is a stable staff group who work well as a team. Staff supervision takes place and training is given a high priority. Most care staff are trained to NVQ level 2. The management team are supportive and forward looking. There is a robust system for recruiting and training new staff and appropriate checks are carried out. Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 6 There is a corporate complaints procedure, although most day to day difficulties are dealt with on an informal basis. There is a clear safeguarding adults procedure and staff have received appropriate training. An independent quality assurance exercise found that the overall quality of care was rated as ‘good’ or ‘excellent’ by residents and their advocates. 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. Red House DS0000035768.V341134.R01.S.doc Version 5.2 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.V341134.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available to ensure residents can make an informed choice about where they live. The intermediate care ‘assessment’ beds make a useful contribution to enabling appropriate care to be provided to older people. EVIDENCE: Copies of the statement of purpose (recently updated), the service user guide, and a copy of the latest inspection report are available in the foyer. Prospective residents or their advocates are encouraged to visit prior to making a decision to move to the home. Copies of the home’s assessments were seen on care planning documentation of case tracked residents, as were Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 9 copies of assessments provided by social services staff. It was noted that the new computer based system should aid the availability of up to date information to assist in providing appropriate care for residents. However, one document seen on a case tracked residents file had not been fully completed, nor was it signed. It is understood that the home manager has discussed the quality of documentation with the local assessment teams. The home has some intermediate care beds, which are used as ‘assessment beds’. The home have a document that details clear criteria for the use of assessment beds, one of which is to ‘help ascertain the real needs of service users and how and where these can be best met’. Admission to an ‘assesment’ bed hopes to prevent premature hospital admission and to ‘help older people regain sufficient physical functioning and confidence to return to their own home’ where possible. The inspector was informed that generally this system works well, although sometimes admissions are taken in an emergency and little information is available to the home at the time of admission. Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 10 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): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are completed and are individualised to demonstrate that residents’ health, personal and social care needs are being met. . EVIDENCE: Three case tracked residents had clearly arranged care planning documentation. Items in files included monthly reviews, personal service plans, risk assessments (moving and handling, nutrition), weight monitoring, and detailed day to day logs. The home are moving to a new computerised Framework I system. Current personal service plans on the new system were brief and could include information on previous personal service plans (which are also on file and still being used). Most information recorded was resident focussed and individualised e.g. including food preferences, personal Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 11 preferences, etc. Some case tracked residents had detailed daily routines and personal histories recorded. Personal service plans could be improved further by cross referencing them with risk assessments and other detailed information. There was evidence that care plans are regularly reviewed and these were recorded on the care planning documentation of all case tracked residents. Derbyshire County Council has a clear policy relating to equality. Staff were observed supporting and reassuring residents. Issues regarding privacy and dignity were dealt with sensitively. A resident returning from hospital was welcomed. Residents and relatives said the staff were ‘good’ and they were treated with dignity and respect; ‘staff can’t do enough for you’, ‘you can have a bit of fun’, ‘I am highly satisfied’, ‘staff will discuss anything you want to discuss’. Aspects of residents’ health needs and medication were clearly presented on care planning documentation. The manager said that they had a good relationship with local GPs and district nurses. Some individual issues regarding support to residents were discussed with the manager. There is a key worker system in place and this is valued by both staff and residents. The home uses the Monitored Dose system (MDS) for most medication, and some medication is kept in original packaging for short term care residents. There is a separate medication room where medication is kept securely. Pictures of residents are kept with their medication administration records, reducing the possibility of residents being given the wrong medication. The manager explained the system of medication administration, which had been developed in line with specialist advice. Some residents administer some of their own medication, which is kept securely. Appropriate assessments have been carried out and were seen. The medication records of some case tracked residents were seen and found to have been recorded correctly. The date of opening had been recorded on eye creams. The fridge temperatures were being monitored. The home have a system for storing and administering controlled drugs. These were checked and found to be correct. The home have access to medication information about particular drugs and their uses and side effects. The home are working to ensure all aspects of the home’s practice are in line with current Derbyshire County Council guidelines. Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 12 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): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides suitable activities and the quality of catering is good which contributes to a pleasant atmosphere and the overall levels of satisfaction for residents. EVIDENCE: There is an activities organiser and records are kept of activities undertaken. The home have worked hard to develop an imaginative approach to activities. Regular events include going on outings, playing bingo, in house entertainment, movement to music, craft, seasonal events, and special events e.g. an Italian evening had taken place, a jazz afternoon was planed for a few days after the inspection. Residents meetings take place regularly. Activities are regularly reviewed by the service manager during regulation 26 visits. The Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 13 home plan to continue to develop activities, particularly to benefit some residents who have dementia or short term memory problems. Residents and a relative confirmed that visitors to the home are welcomed and that the home is very flexible when visitors come for special occasions. Most residents have regular contact with relatives and friends and some go out on a regular basis. Residents spoken to confirmed that they could follow their own routines. Some residents had formed special friendships and supported each other. Other residents preferred to be more private and spend time on their own. The manager said the home did everything possible to support residents meet their cultural and religious needs. Meals are served in the lounge/dining areas and in the main dining room. All residents and a relative spoken with were complimentary about the standard of catering, and the choice of menus that are available: ‘the food is excellent’. Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 14 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): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear and accessible complaints and safeguarding adults procedures are in place to ensure residents can be confident that any issues raised would be acted on effectively and promptly. EVIDENCE: There is a corporate complaints procedure, although most relatives and residents prefer to raise issues on a more informal basis, ‘I have no complaints’, ‘if something is wrong I would talk to management’, ‘I sleep well, I have no worries’. The complaints procedure leaflet is available the foyer and complaints information is in the statement of purpose and service user guide. No formal complaints have been made to the home or to CSCI. Derbyshire County Council has clear procedures for dealing with the safety of residents and safeguarding them from harm. Staff spoken to showed an awareness of safeguarding adults issues, were clear about their responsibilities Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 15 and would pass any concerns on to their line manager. Training in safeguarding adults has been provided for new staff, but established staff have not undertaken safeguarding adults training for some years. Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 16 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): 19, 20, 21, 24, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides residents with an attractive and homely place to live. EVIDENCE: The home provides a homely, relaxed environment for residents. There are a variety of lounge and dining areas so residents have a choice of where they spend their time. Standards of decoration and furnishings are good, and there is a rolling programme of decoration and maintenance. Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 17 The area outside the home has been refurbished with a new patio area and a new ramp for access to the patio area, creating an attractive and peaceful place for residents to spend their time in good weather. Several residents told the inspector they enjoyed spending time in the garden. There has been considerable investment in the home and all the bathrooms have been completely refurbished creating attractive and fresh bathrooms and shower rooms. The area of flat room is awaiting some planned maintenance. The lift is quite old and is difficult for some residents to use, but is maintained regularly. Residents spoken with on the day of inspection were satisfied with their bedrooms. Four were seen and were satisfactory and had been personalised. A resident told the inspector that her bedroom is nice and ‘the beds are comfy’. Residents were satisfied with the standard of cleaning and described the home as ‘spotless’, and ‘fresh’. Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 18 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): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A trained and competent workforce are in place which meet the dependency needs of residents currently accommodated within the home. EVIDENCE: On the day of inspection there were sufficient care staff to meet the needs of residents accommodated within the home. The current rota has two care staff on at all times. Managers help out in the mornings with providing care to residents. However, both staff and managers are aware of the increasing needs of residents when they are admitted. The needs of current long term residents are also increasing, including the number of residents who have confusion or short term memory loss. A good practice recommendation has been made to formally monitor dependency levels to enable additional staff to be brought in when dependency levels are high. This is particularly important as there are two intermediate care ‘assessment’ beds where residents may be admitted in emergencies (with a 72 hour review), as well as three short term care beds. A member of staff commented ‘we are always very busy, but sometimes we are too stretched’. Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 19 Several of the managers have undertaken dementia care training and one of the deputy managers has undertaken training in ‘dementia care mapping’. This increases staff understanding of how to effectively provide a good service to residents. Red House work closely with other homes in the area to share good practice ideas on dementia care and other issues, e.g. activities. An appointment has been made to cover a care staff vacancy, and staff are currently working extra hours to cover vacancies, sickness and staff holidays. There is a stable staff group and this continuity was appreciated by residents, several of whom commented on the good relationship they had with their key worker. Staff spoken to were responsible, competent and committed to the welfare of residents. Staff said ‘we work well together as a team’. They enjoyed their work, and were proud of the standards of care given; ‘residents see staff like a family’,’ relationships are very important’, ‘we relate to residents as individuals, we enjoy our jobs’, ‘the residents here get a good standard of care’. The inspector was informed that mandatory training for moving and handling, fire safety, and basic food hygiene was up to date for all staff. Derbyshire County Council have made a big commitment to staff training and nearly all staff have at least NVQ Level 2. However, training opportunities for established staff could be expanded to include updates on dementia care, equality and diversity, infection control, bereavement and counseling, and safeguarding adults. One member of staff commented ‘training courses seem to e very full nowadays’. Two staff files were seen and had evidence of CRB checks having been carried out. Copies of application forms and references are available centrally. The inspector was informed that Derbyshire County Council are moving to a new system of organising Human Resources information, including staff training records. However, the home keep their own individual staff training records and plan to continue to do so. Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 20 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): 31, 33, 35, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is suitably qualified and experienced and staff demonstrate an awareness of their roles and responsibilities, thus ensuring the home is run in the best interests of residents. EVIDENCE: The manager has the required qualifications and experience to fulfil the responsibilities of her role. There is a management team and individual deputies take responsibility for various aspects of the day to day running of the home and for staff supervision. The manager said the team work closely Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 21 together to provide support for each other and the staff. Staff said: ‘we can raise things in staff meetings’, ‘the managers are very approachable’. Staff and managers said that there is a system of staff supervision, and generally speaking this is effective and up to date. A quality assurance exercise was held last year and found that residents felt the quality of service they received was good or excellent for all aspects of the service provided. The information obtained through the qualify assurance exercise is made available to the residents. The only suggestion made was that some residents would like some larger chairs. The inspector was informed that the home has a computerised system for managing service users’ finances, which appears to work satisfactorily. The inspector was informed that the home is moving towards a computerised system for managing service users’ finances. At present residents finances are kept in the safe and manual records kept, which appears to work satisfactorily. The information provided by the manager prior to inspection indicates that the home makes every effort to ensure safe working systems are in place and equipment maintained satisfactorily. Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 22 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 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 4 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 23 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. 1 2 3 4 5 Refer to Standard OP7 OP7 OP19 OP27 OP30 Good Practice Recommendations Personal service plans should be improved further by cross referencing them with risk assessments and other detailed information to ensure residents safety. Resident dependency levels should be formally monitored to ensure that staffing levels are sufficient to meet residents’ needs at all times. Consideration should be given to replacing the current lift which is difficult for some residents to use because there are two doors which have to be opened manually. Staffing should be increased as resident dependencies increase to ensure that residents’ needs are met at all times. All staff should have up to date training in dementia care, safeguarding adults, equality and diversity, and bereavement, to assist them in caring for residents. DS0000035768.V341134.R01.S.doc Version 5.2 Page 24 Red House Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Red House DS0000035768.V341134.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!