Inspection on 19/04/06 for Red House

This inspection was carried out on 19th April 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Red House 13/08/07

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 19th April 2006 10:30 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.V289630.R01.S.doc Version 5.1 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.V289630.R01.S.doc Version 5.1 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.V289630.R01.S.doc Version 5.1 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. 10th November 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.V289630.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over six hours. During the inspection 10 residents, 3 relatives/friends, and 4 staff members, including two of the deputy managers, were spoken with. The Manager was present throughout the inspection and provided assistance and information. A tour of the part of the building took place. A number of records were examined, including risk assessments and care plans, health and safety documentation, staff files, and Regulation 26 visit records. An assessment was also made of the progress by the registered persons to address requirements made at previous inspections. Three residents were case tracked. What the service does well: What has improved since the last inspection? What they could do better: Work to improve the building and grounds had not been carried out as originally scheduled and as per previous requirements. Two timescales for the compliance with this requirement have passed. This work includes substantial improvements to the bathrooms which would upgrade the facilities and improve the service offered to residents. An immediate requirement was left Red House DS0000035768.V289630.R01.S.doc Version 5.1 Page 6 on the day of inspection regarding improvements needed to the downstairs bathroom. Requirements for this inspection have been made detailed and specific to give additional timescales to the schedule. The planned work to the grounds of the home would allow all residents to safely access and enjoy the gardens. 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.V289630.R01.S.doc Version 5.1 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.V289630.R01.S.doc Version 5.1 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): 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home have a system for assessing residents’ needs to ensure that the care provided can meet residents’ needs appropriately. The home provides an intermediate care service that helps maximise residents’ independence. EVIDENCE: Assessments are carried out in the community by social workers and care managers. Potential new residents are invited to spend a day at the centre with their relatives, and this is used to verify assessment information, provide the service user with information and choice, and undertake any further assessments. An evaluation is completed at the end of this visit, and examples of this were shown to the Inspector and provide useful additional information. Red House DS0000035768.V289630.R01.S.doc Version 5.1 Page 9 The inspector was informed that the assessment care beds are currently underutilised, and that consideration was being given to ‘relaunching’ the service. The criteria for assessment and admission were made available to the inspector. Short term care and permanent beds are usually fully occupied. Red House DS0000035768.V289630.R01.S.doc Version 5.1 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 at least once during a 12 month period. 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. The care plans relating to personal and social care needs of residents were detailed. Residents are encouraged and supported to be independent and to exercise choice in all aspects of the home and are treated with dignity and respect. This contributes to the enhancement of residents’ everyday lives. EVIDENCE: All case tracked residents had detailed personal development plans, monthly updates, daily logs, evidence of regular reviews, daily routines and various risk assessments and monitoring forms. Information recorded on care plans was presented clearly and was informative. Residents had signed documentation indicating that care plans had been discussed with them. Information regarding residents is kept on their personal file, the care plan file (containing personal development plan), and daily logs (which are kept together for all residents). Red House DS0000035768.V289630.R01.S.doc Version 5.1 Page 11 The administration of medication was inspected and records found to be up to date. The home has a separate medication room with the medicines trolly, fridge and controlled medication cupboard. A larger medication trolley and storage cupboard would be beneficial as it would allow more space for medication for assessment and/or short term care residents. A tube of eye ointment did not have the date of opening noted on it. Night staff have not been training in the administration of medication, but the inspector was informed that all medication is administered by suitably trained staff before they leave; that night staff have been trained in house in administering and recording homely remedies; and that no pre-dispensing takes place. Some residents are able to administer their own medication, which is kept securely in their rooms. One member of staff, a deputy manager, has the main responsibility for ordering medication which is then checked by the manager. Residents spoke very positively about staff and said they were treated with dignity and respect. Confirmation was given that they are given choice and are able to follow their own routines. Information about likes and dislikes, and preferred routines is recorded on personal development plans. The home have an equal opportunities policy and staff and the manager had an understanding of disability and gender issues. It was recognised that the current arrangements in the garden mean that they cannot be enjoyed safety by residents with mobility difficulties. One gender issue was discussed in detail with the manager. Red House DS0000035768.V289630.R01.S.doc Version 5.1 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 at least once during a 12 month period. 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. Activities are provided that generally suit the expressed preferences of residents. Regular outside contacts are encouraged and supported. This assists in contributing to a pleasant atmosphere and the overall high level of satisfaction for residents. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets residents’ tastes and choices. EVIDENCE: Residents interviewed reported that they felt the home provided suitable activities and catered for their interests. There is a section in the care planning documentation that details residents involvement in activities. Several residents told the inspector of their favourite pastimes, and how they enjoyed outings. Other residents preferred to spend time on their own, and this was respected. There was a notice board detailing daily activities, monthly entertainment, and outings. There is a regular residents meeting. Red House DS0000035768.V289630.R01.S.doc Version 5.1 Page 13 Residents are looking forward to outings in the summer, and to spending time in the garden in the better weather. Improvements are needed to the patio and garden paths to ensure the garden can be enjoyed safely. Several residents are able to go to local shops or into Chesterfield. Residents indicated that they feel staff are approachable and any problems can be discussed with them or with one of the managers. All indicated that they are able to exercise choice about aspects of their daily lives. Some significant friendships and support systems have been developed amongst some residents, who have very different needs. All residents spoken to were complimentary about the standard of catering, and the choice of menus that are available. Menus are displayed on the ‘day’ notice board. Residents said that the food is always well presented. One resident spoken to had recently celebrated a birthday. Red House DS0000035768.V289630.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. 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. There are systems in place which promote the protection of residents from abuse and neglect. A robust complaints procedure is in place. EVIDENCE: There is a complaints procedure displayed in the reception area which is readily available to both residents and their visitors. This specifies how complaints can be made and that they will be responded to within 28 days, written information on how a complaint can be referred to the Commission for Social Care Inspection is included. The complaints records were seen and one recent issue was discussed. Residents confirmed that they would discuss any concerns with the manager, although all residents spoken to emphasised that they had no complaints. A discussion took place with the manager, who is aware of adult protection issues. Staff have had training in adult protection. Staff spoken to showed an awareness of adult protection issues and would pass any concerns on to their line manager. Red House DS0000035768.V289630.R01.S.doc Version 5.1 Page 15 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): 19,20, 21,23, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Apart from the bath/shower rooms and paths and patio in the garden, the home was suitable for its stated purpose and generally 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: Communal areas are attractive and homely and give residents a choice of environment. There is also a quiet room where residents can receive visitors or use the telephone privately. All bathrooms require refurbishment and decoration; an immediate requirement was left on the day of inspection for the downstairs bathroom which is missing ceramic tiles and therefore cannot be cleaned adequately and is unsightly. One upstairs bathroom had a cupboard that presents a hazard. Routine maintenance is required to clear the flat roofs adjacent to the upstairs corridor. Work is required to the patio and garden Red House DS0000035768.V289630.R01.S.doc Version 5.1 Page 16 paths to make them safe for residents’ enjoyment of the garden. The lift is difficult for some residents to use because there are two doors which have to be manually opened. The lift requires regular maintenance to ensure safe operation. Some metal handrails have had to be taped to make them safe. All residents said they were very pleased with their bedrooms, which were comfortable and homely, and which they were able to personalise. All areas of the home seen on the day of inspection were clean and tidy and well presented. Red House DS0000035768.V289630.R01.S.doc Version 5.1 Page 17 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): 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. Staff are trained and competent to do their jobs. EVIDENCE: The rotas discussed and found to provide adequate staffing to meet residents needs at the current time, although staff were often very busy and needed help from the manager on duty to provide care to residents. It was noted that currently there are several residents who require very little personal care. Some extra hours are available, but only for use with the residents occupying assessment beds. Continued vigilance will be needed to ensure that staffing levels continue to meet residents needs as current residents become more dependent. Extra hours for busy times, e.g. when residents get up in the mornings, would benefit both residents and staff. The manager said that generally staff worked as a team and were well established with a stable staff group. Staff spoken to were responsible and enthusiastic, and were observed being responsive to residents needs. There is a team approach to work, and staff said they feel well supported by both their colleagues and their managers. Red House DS0000035768.V289630.R01.S.doc Version 5.1 Page 18 Staff files seen had evidence of some CRB checks, copies of contracts, but did not have copies of references, although copies of all recruitment documentation is held centrally. Derbyshire County Council has a thorough and detailed recruitment and selection procedure. Discussion with staff indicated that they felt they were offered good training opportunities and all staff spoken to were keen to make use of these. Most staff have been trained to level NVQ2. Training plans were discussed with the deputy manager responsible for training who said that training in mandatory courses was up to date. Recent training has included moving and handling updates, fire safety and infection control. Red House DS0000035768.V289630.R01.S.doc Version 5.1 Page 19 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): 31, 32, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager provides clear leadership throughout the home with staff demonstrating an awareness of their roles and responsibilities ensuring that the home is run in the best interests of the residents. EVIDENCE: Residents and staff spoke positively about the manager and the management team. Each member of the management team takes responsibility for a particular area of the running or the home, and this system is felt to work smoothly. The inspector was informed that staff have regular supervision and this was confirmed by staff spoken to. The home is visited regularly by a representative of the registered person and Regulation 26 visit reports were made available to the inspector. These Red House DS0000035768.V289630.R01.S.doc Version 5.1 Page 20 indicated that matters of day to day management are dealt with in a timely fashion (apart from the matters highlighted in the requirements), and the Service Manager regularly consults with residents about the quality of the service provided. The inspector was informed that the home is moving towards a computerised system for managing residents’ finances. At present residents finances are kept in the safe and manual records kept, which appears to work satisfactorily. Residents had been formally consulted during a quality assurance exercise, but the results had not been formally recorded or made available. A variety of health and safety records were looked at. Gas safety testing; portable electrical appliance testing and other maintenance documents were seen: all were satisfactory apart from the electrical hard wiring certificate which was out of date. This work must be undertaken to bring the electrical certificate up to date and ensure safe working practices are in place. Portable electrical appliance testing was due in May. Red House DS0000035768.V289630.R01.S.doc Version 5.1 Page 21 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 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 1 X 3 X X 2 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 2 Red House DS0000035768.V289630.R01.S.doc Version 5.1 Page 22 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 Timescale for action 31/07/06 2. OP29 19 The registered manager must ensure that the planned improvements to the home are carried out to the agreed schedule. Original timescales 31/10/05 and 31/03/06 – see timescales below The records of all staff employed 30/06/06 at the home must include all the items detailed in Schedules 2 and 4. Original timescale 31/03/06 The cupboard in the upstairs bathroom must be made safe as it is currently a health and safety hazard. Original timescales 31/10/05 and 31/03/06 Repairs must be carried out to the downstairs bathroom which is missing ceramic tiles and therefore cannot be cleaned adequately and is unsightly. The Commission must be informed whether the this work will be carried out on its own or as part of the refurbishment of the bathroom. An immediate requirement was made in DS0000035768.V289630.R01.S.doc 3 OP21 23 (2) (b) 30/06/06 4 OP21 23(2)(b) and (2)(j) 31/05/06 Red House Version 5.1 Page 23 5 6 OP19 OP20 23 (2) (b) 23 (2) (b) 7 OP38 23 (2) (b) relation to this matter, which was subject to the timescales in requirement 1. Original timescales 31/10/05 and 31/03/06 Routine maintenance is required to clear debris off the flat roofs adjacent to the upstairs corridor Work is required to the patio and garden paths to make them safe for residents. Original timescales 31/10/05 and 31/03/06 An up to date electrical hard wiring certificate must be obtained. 30/06/06 31/07/06 30/06/06 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 OP9 Good Practice Recommendations Consideration should be given to obtaining a larger medication trolley and storage cupboard which would allow more space for medication for assessment and/or short term care residents. Night staff should have formal training in administration of medication. Tubes of eye ointment and bottles of eye drops should have the date of opening noted on them. Consideration should be given to replacing metal handrails with wooden handrails. 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. Consideration should be given to increasing staffing at busy times, e.g. when residents get up in the mornings. Residents have been formally consulted during a quality assurance exercise, and the results should be formally recorded and made available. 2 3 4 5 6 7 OP9 OP9 OP19 OP19 OP27 OP33 Red House DS0000035768.V289630.R01.S.doc Version 5.1 Page 24 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 © 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.V289630.R01.S.doc Version 5.1 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. 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