Inspection on 23/07/07 for Red House

This inspection was carried out on 23rd July 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Red House 09/08/06

Red House 18/01/06

Red House 13/07/05

Red House 03/11/04

Red House 03/06/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Red House Gas House Lane Main Street High Bentham North Yorkshire LA2 7HQ Lead Inspector Linda Trenouth Key Unannounced Inspection 23/07/07 11:30 Red House DS0000007899.V335902.R01.S.doc Version 5.2 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 DS0000007899.V335902.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 Adults 18-65. 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 DS0000007899.V335902.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Red House Address Gas House Lane Main Street High Bentham North Yorkshire LA2 7HQ 01524 262694 F/P01524 262694 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) www.st-annes.org.uk St Anne`s Community Services vacant post Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Registered for 5 service users with learning disabilities, some of whom may have physical disabilities, all of whom may also be aged 65 years or older. The home may not admit any service user within the service user category (LD(E)). This category applies to those service users currently in receipt of services. 9th August 2006 Date of last inspection Brief Description of the Service: Red House is a care home registered by St. Annes Community Services to provide personal care and accommodation for up to five adults with learning disabilities some of whom may have physical disabilities and all of whom may be aged 65 years or older. The home consists of a two storey detached house situated on a quiet lane in the market town of High Bentham. The town centre is within easy walking distance of the home and has numerous and varied facilities including shops, cafes, churches and pubs. All five bedrooms are for single accommodation, none of which has en-suite facilities. Shared areas consist of a kitchen, dining room, and lounge. The home has a large, landscaped garden that is well maintained. There is hard standing for resident parking to the rear of the home. There is level and ramped access to the home. The current weekly fee for the home is £252.96 extras that are charged for are hairdressing, chiropody, toiletries, aromatherapy and holidays and the leasing of cars. Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows a surprise visit to the home. The inspection also included gathering information and facts before and after the visit to decide the overall judgement. The home does not have a registered manager, but a manager from a sister home is over seeing this home until a manager is appointed and registered. The acting manager was not at the home during the inspection but was contactable by telephone. During the visit I looked at the records, watched staff working, and talked to people who live at the home. I also looked around the building. The main purpose of this inspection is to make sure that the home continues to provide a good standard of care. Comment cards were sent to people who use the service, to give them the opportunity to comment on how well they thought the home had done. I contacted the acting manager by telephone the next day about the outcomes of this inspection, the requirements made during this visit can be found at the end of the report. What the service does well: People who use the service are given good information about what is provided. This means that they know what help they will be given. People who would like to move into the home are assessed so that they and the staff team can be sure that their needs will be met. People are involved in deciding what care they need and a plan is then drawn up. This gives everyone a say in planning services they will receive. The staff showed a good understanding and knowledge of people that live at Red House. They look after them in a friendly and supportive way. People see their GP, dentist, optician, and chiropodist whenever they need to. This ensures that their health care needs are met. People are clearly encouraged to maintain relationships with friends and family. This promotes their emotional wellbeing. Everyone is asked what they think about the service provided so that the staff team can make changes to improve their quality of life. Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 6 People living at the home are involved with planning menus and have a good choice of food and drinks at mealtimes. This ensures that they have a varied diet of their choosing and can enjoy their meals. The staff enable and encourage people to participate in the local facilities in the Bentham and Craven areas. 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 DS0000007899.V335902.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 and 5. People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People have good information about the home and are only admitted after assessments have been made to make sure the home can meet their needs. People are not provided with the support they need to understand and agree contracts with the home so are not fully aware of all their rights. EVIDENCE: The service user guides and complaints procedures are in place and each person has their own copy. The guide is written in an easy read style to meet individual communication needs. This makes sure that everyone has access to the information they need to tell them what the home can provide. There have been no new admissions but one person has transferred from another home in the area owned by the same company. The documents and reviews are in place and the individual visited the home several times before he decided to move in. There are important documents such as terms and condition of living at the home and leasing agreements for the cars, which had only been signed by the Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 9 manager of the service. Some people at the home may not have the capability or capacity to understand such legal agreements. People may need additional support from relatives or an advocate to make such important decisions. This support is important to make sure that people are properly involved in making important decisions in their lives and their rights are adequately protected. Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 and 10. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People are able to make their own choices about how they live their lives both in the home and the wider community. EVIDENCE: Assessments and care plans are completed and regularly reviewed. This makes sure that the changing needs of people living at the home are continually met. Staff explained how they include people in understanding their care plans and made sure that they are involved in any change of decisions within them. Staff also have good communication and understanding of how to meet the communication needs of individuals. There is a section in the care plan about preferred communication and additional guidance is available for staff to help them improve and help people make day-to-day decisions. Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 11 Staff are able to give good examples of how they support individuals, they discussed how they encouraged people to individualise their rooms and choose items they would like. Another example is personal care and encouraging people to be as independent and self-reliant as they can be. Other staff said that they encourage everyone to be involved with the menus, the choice of food and help with the shopping. The people I saw and spoke with at the home are all over 65 years old and staff provided a calm and comfortable environment. I saw that people were enjoying various activities during the day. The questionnaires that were returned confirmed that everyone is happy with the choices they made. Each individual has a special worker who is called a “key worker”, who includes them in their care planning and there are regular house meetings where people are able to further express their views. Care documentation is held in a bookcase in the hallway of the home and must be removed to the office or placed in a lockable storage facility. The manager must make sure that an individual’s personal information is kept safe and confidential. Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14, 15, 16 and 17. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The people who live at the home have good opportunities to experience and enjoy fulfilling lives both within and outside the home. EVIDENCE: There are varied activities happening throughout the week, which are appropriate to the needs and abilities of the people living at the home. One individual told me about how he really enjoyed the trips out that he and the staff went on. He particularly liked going on the train and had recently been to the seaside for a short break. He had sent a postcard to his sister, which the staff had helped him with. Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 13 Other individuals attend age concern’s lunch club and some have previously been encouraged to attend college. A diary of all their activities for the month are in the kitchen, this allowed for some planning but staff said that there are also spontaneous activities on the day depending on the weather. The survey cards returned confirmed that people felt there are lots of activities on offer. Individuals are supported to practice their faith and one individual attended his local church when he wished. People are supported to develop and maintain relationships with families and friends. They are assisted to visit their families and can meet their visitors in private. The mealtime is not rushed or hurried. People are clearly relaxed with the staff and the atmosphere is pleasant, where necessary staff help people with their food in a sensitive and supportive manner. Most main meals are eaten together at the home and staff told me that individuals also eat out regularly at pubs, cafes, and restaurants. They sometimes have fish and chips from the local fish and chip shop. There is good, friendly supportive rapport between the staff and people living at the home. Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The staff make sure that the people who live at the home stay fit and healthy. Medication is administered safely at the home to make sure that all people using the service are kept healthy and well. EVIDENCE: Staff provide good support with personal care in a way that promotes the person’s privacy and dignity. From discussion with staff and review of records it is evident that each individual is registered with a local GP and is supported by staff to attend any healthcare appointments. Other health care needs are met including visits to the optician, dentist and chiropodist and people are also supported by additional specialist health care services where required. Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 15 Everyone has their medication administered by staff. This is well recorded and all medication is securely stored. All staff have undertaken medication training with Thomas Danby College based in Leeds. The medication provided to the home is in a monitored dosage system supplied by the local Chemist. Staff said that the pharmacist is very supportive and collects the returned medication weekly. Drug administrative documentation is in order although the home should update their drug reference book to make sure they keep fully informed of all medication. Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People’s concerns are listened to and they are safeguarded from any possible harm. EVIDENCE: The complaints procedure is available in the service user guide in an easy read style and staff have access to grievance and complaints procedures in their own policies and procedures. People living at the home are able to let staff know if they are unhappy, the staff then attempt to address this promptly and appropriately. Staff have developed very good relationships with individuals and clearly have a good understanding of their communication needs. There are also regular house meetings and team meetings for people who live at the home and staff to raise any concerns they may have. There is an adult protection procedure in place and staff showed a good awareness of adult protection. Staff have regular training in adult protection, this helps them understand how they can protect vulnerable people. I confirmed with the staff that there have been no complaints sent to the home; the complaints book did not have any complaints or concerns recorded and no complaints have been made to us within the last twelve months. Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 28 and 30. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The home is comfortable and homely and is suitable and meets the needs of the people who live there. EVIDENCE: The people at the home and the staff did not know that I was going to visit. The home was very clean and tidy. Staff said that they clean the home, but also encourage the people who live there to be involved where possible. The laundry and kitchen areas had been repaired since the last inspection with all tiling work completed. Staff confirmed that all equipment is working. The bedrooms I saw were individualised and furniture is chosen and bought by the individuals themselves. The bedrooms reflected the individual tastes of each person. They also had TVs and CD players and one individual said that he liked to spend time in his room listening to music. He said he really liked Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 18 his room and had a lock on his door, but could not manage a key staff so staff locked it for him upon his request. He liked his privacy and felt that staff helped make sure that it is respected. Communal areas are homely and provide a safe and comfortable environment for everyone. The maintenance work that needed to be done in the kitchen, laundry and garden has been completed making a more comfortable and safe home for people to enjoy. The acting manager has delegated key staff to be responsible for the monitoring and maintenance of health and safety in the home. This makes sure that everything is checked regularly, repaired and that everyone is safe. The gardens were being tended to during the visit and provide a good area and additional space for people in the better weather. The home has some additional funds available and people have been involved in deciding what they will spend it on. They have decided that they would like to buy a summerhouse and additional garden furniture so that they can enjoy the garden throughout the year. Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The people at the home benefit from a well-supported and trained staff team who are competent and understand their needs and work in the best interests of each individual. EVIDENCE: Staffing levels meet the needs of people with individuals supported with one to one staffing where required. The staffing roster for this week shows that staff are employed in sufficient numbers and are deployed in such a way as to ensure that the needs of people living in the home are met at all times. New staff confirmed they had completed induction training and are now on the LDAF (learning Disabilities Award Framework) training. Other staff said that training is good and they felt it is regularly updated, this included food hygiene, health and safety and adult protection. Also an opportunity for Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 20 further specialist training is available and the staff confirmed completion of NVQ (National Vocational Qualification) award level 3. The staff training is audited by the manager on a training matrix. This matrix gave a clear indication of training needs and updates. The percentage of staff now trained to NVQ level 3 is 50 of staff working at the home. Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The health and safety of everyone is well protected by regular auditing and review of safety. EVIDENCE: The home does not currently have a manager in post but arrangements have been made for the registered manager of a sister home to also oversee the management of Red House until the current re-profiling of services has been completed and a decision about the future of the home is made. At this stage a registered manager must be appointed. The service manager undertakes monthly audits of the service and visitors to the home have been asked to complete quality questionnaires. The views of Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 22 people living at the home are also sought, making sure that everyone has a say in running the home. Monthly health and safety checks are completed with staff at the home being given delegated responsibilities for specific areas. The following areas were reviewed at the visit and are satisfactory. Fire safety systems and records, PAT (Portable Appliance Testing), hoist maintenance, electrical and gas safety certificates and water temperatures. Further health and safety records show that COSHH risk assessments are in place. The home has notified us when there has been an occurrence affecting the well being of an individual living at the home. Staff said that they had regular staff team meetings and supervision and felt that the home is well managed. Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 X 2 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X 3 3 X Red House DS0000007899.V335902.R01.S.doc Version 5.2 Page 24 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. 1 Standard YA5 Regulation 5 Requirement People using the service must be given the support they need to enable them to make decisions with respect to their contracts and car lease agreements. All records relating to an individual must be stored in a safe place where confidentiality Can be assured. Timescale for action 01/10/07 2 YA10 17 01/10/07 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 YA20 Good Practice Recommendations The home should update their drug reference book to make sure they keep fully informed of all medication. 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