Inspection on 09/08/06 for Red House

This inspection was carried out on 9th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Red House 23/07/07

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 Mrs Maggie Coxon Key Unannounced Inspection 9th August 2006 10:00 Red House DS0000007899.V307308.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.V307308.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.V307308.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 01524 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) St Anne’s Community Services *** Post Vacant *** Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Red House DS0000007899.V307308.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. 18th January 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. Information provided by the previous registered manager on 31st May 2006 indicated that the current monthly fee for the home is £995.69. Red House DS0000007899.V307308.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an unarranged site visit undertaken by one Regulation Inspector on the 9th August 2006. This visit took 4 hours plus 3 hours preparation time. This site visit forms part of the first key inspection of this home since April 2006. During the visit some areas of the home and a number of records were seen. Also seen was how staff worked with and spoke to the residents and discussions were held with all four residents and several staff. Information was also used from the pre inspection questionnaire provided before the visit. What the service does well: Staff know and look after residents very well and provide help in a friendly and supportive way. Residents can be confident that they will get good support. Residents can develop and maintain relationships with friends and family. This promotes their emotional wellbeing. Residents are given information about what services are provided. This means that they know what help they will be given. Prospective residents are assessed so that they and the staff team can be sure that their needs will be met should they move into the home. Residents are asked to say what care they need and a plan is then drawn up. This gives residents a say in planning services they will receive. Residents see their GP, dentist, optician and chiropodist whenever they need to. This ensures that their health care needs are met. Residents and their visitors are asked what they think about the service provided so that the staff team can make changes to improve residents’ quality of life. Residents 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. Red House DS0000007899.V307308.R01.S.doc Version 5.2 Page 6 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. Red House DS0000007899.V307308.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.V307308.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. Quality in this outcome area is good. A comprehensive assessment process and information provided gives prospective service users an opportunity to choose if they want to move into the home. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Well-detailed information about services offered is included in the home’s statement of purpose and service user guide. This information is made available to prospective service users so that they can decide whether or not the service can meet their needs prior to moving in. A pre-admission assessment was undertaken on each of the service users prior to their admission to the home. This information was made available to staff to ensure that they would know about the social, personal and emotional needs of the individual before they moved in. Red House DS0000007899.V307308.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Quality in this outcome area is good. Service users make many decisions and everyday choices. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Service users’ care plans contain sufficient detail to ensure that staff know how best to meet the diverse needs of the individual in a way that promotes their independence wherever possible. Service users have recently met with management representatives from St Annes Community Services to discuss their wishes regarding future care provision and individual action plans are being drawn up. Service users make many choices in their daily lives and are allowed to take reasonable risks subject to an individual risk assessment that is fully recorded. Red House DS0000007899.V307308.R01.S.doc Version 5.2 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. Quality in this outcome area is good. The range of activities enjoyed by service users is varied and individually tailored giving them opportunities to meet their social needs. Service users are supported to develop and maintain personal relationships, thereby meeting some of their emotional needs. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Service users have a variety of activities that they participate in outside in the community and several were seen to do so during the visit. Routines in the home are very relaxed, one of the service users explained that they choose when to get up on a morning. Staff were seen to speak to service users and to support them in a very positive and friendly manner. Red House DS0000007899.V307308.R01.S.doc Version 5.2 Page 11 Staff explained that two of the service users have a foot massage every other week from a visiting masseuse. They also said that they are in the process of arranging holidays for each of the service users. Service users are well supported to develop and maintain personal relationships of their choosing. Service users have a choice at mealtimes; this was observed during the visit. Lunchtime was very relaxed and informal. Records of meals provided identify that meals are varied and generally nutritious. Red House DS0000007899.V307308.R01.S.doc Version 5.2 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is good. Service users’ personal care and healthcare needs are being met. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Staff were seen to provide support with personal care needs in a way that promoted the service user’s privacy and dignity. Case tracking identified that each service user is registered with a GP and is supported by staff to attend any healthcare appointments. All of the service users have their medication administered by staff. This is well recorded and all medication is securely stored. All staff have undertaken appropriate medication training. Red House DS0000007899.V307308.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. Service users can be confidant that any concerns and complaints will be listened and responded to and that they will be protected by trained staff. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A comprehensive complaints procedure is followed. One of the service users said that he would speak to staff if he had a concern. In the case of service users being unable to verbalize concerns staff observe behaviours and body language to identify any dissatisfaction. There is also a comprehensive adult protection procedure in operation and staff explained that they have recently all undertaken refresher adult protection training. Red House DS0000007899.V307308.R01.S.doc Version 5.2 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is adequate. Whilst the home is clean and tidy there are areas that require refurbishment to ensure that service users’ health, safety and general wellbeing is assured. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Each service user has his own bedroom, which is pleasantly decorated and furnished. One wall in one bedroom however needs redecoration due to surface damage. Various communal areas both internal and external are in need of repair or refurbishment. Whilst new kitchen units have been fitted they have not been adequately sealed in to prevent cross contamination. The water pipe covers in the kitchen and the ground floor bathroom are tatty and need replacing. Wall tiles are insecure in the ground floor bathroom and missing in the laundry. The shower panels in the first floor bathroom are in disrepair and need replacing. Red House DS0000007899.V307308.R01.S.doc Version 5.2 Page 15 One of the wall light fittings in the hallway is not securely fixed to the wall and requires repairing. The handle of the door linking the ground floor bathroom to one of the bedrooms needs repairing. The home has a large landscaped garden which service users spend a lot of time in. Whilst a more solid handrail has been fitted to one set of external steps following a fall by a service user, another set of four steps in the garden has no hand rail at all and could pose a risk to service users. The home was clean, warm and tidy throughout. Red House DS0000007899.V307308.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 and 36. Quality in this outcome area is good. The home is adequately staffed. Appropriate staff training is being undertaken so that service users can be confident that their individual needs and choices will be met. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Robust recruitment procedures are followed It was not possible to examine the personal records of any new staff during this visit because staff on duty did not have access to this information. One of the care staff said however that all of the care staff were in the process of applying for updated CRB checks. Staffing levels were appropriate at the time of the inspection and duty rosters showed that staff are employed in sufficient numbers and appropriately deployed at all times. Staff on duty were knowledgeable about service users’ needs and wishes and worked very well with them. A number of staff have completed NVQ3 and others are currently undertaking the award. It was not possible to examine staff training records because once again staff on duty did not have access to this information. Staff confirmed Red House DS0000007899.V307308.R01.S.doc Version 5.2 Page 17 however that the team all have current training in moving and handling, emergency aid, basic food hygiene, health and safety, rectal diazepam administration, the safe handling of medication and fire safety. Staff also said that they have been receiving regular supervision. Red House DS0000007899.V307308.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. Quality in this outcome area is adequate. Health and safety systems and procedures are in operation although there are some shortfalls in these that could affect the safety and well being of service users. The home is reasonably well run but there is no manager currently in post. This situation could result in less support for staff and subsequently a decline in the quality of services for service users. This judgement has been made using available evidence including a visit to the service. 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. This has been agreed to on a temporary basis because the deputy manager only works Red House DS0000007899.V307308.R01.S.doc Version 5.2 Page 19 part time and staff have not been receiving the level of support they should since the registered manager’s recent departure. The service manager undertakes monthly audits of the service and visitors to the home have been asked to complete quality questionnaires. Service users’ views are sought on an informal basis through chatting. Information from all sources is then fed into the team plan. Monthly health and safety checks of the premises are undertaken. Fire safety records showed however that external fire system checks have not been not recorded since 27/07/05 and that no fire drills are being undertaken by staff. They did show however that weekly alarm tests are being undertaken and that all staff are having regular fire safety training. Further health and safety records show that COSHH risk assessments and product data are in place but hot water outlets including those for full immersion facilities are only being tested monthly. Appropriate measures have yet to be undertaken with regard to the prevention of Legionnaires disease although a system is being piloted by the organization in some of its services. Staff explained that the home had been without hot water during the weekend preceding the visit because of a faulty hot water tank. Hot water for bathing had been made available once more by the Monday and the plumber had called to check the temperature control valves on the morning of the visit. Whilst staff had taken measures to minimize any negative effect on the service users they had not informed the CSCI of this incident as should have been done to comply with regulation 37. Red House DS0000007899.V307308.R01.S.doc Version 5.2 Page 20 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 X 2 3 3 X 4 X 5 X 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 1 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 1 X 3 X X 2 X Red House DS0000007899.V307308.R01.S.doc Version 5.2 Page 21 No. Are there any outstanding requirements from the last inspection? 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 YA24 Regulation 23 Requirement The kitchen units must be completely sealed in to prevent cross contamination. Faulty tiling in the ground floor bathroom and laundry must be repaired or replaced. The shower panels in the first floor bathroom should be replaced. The faulty wall light in the hallway must be repaired or replaced. The unassisted steps in the garden must be made safe for service user use. The situation concerning the future management of the home must be closely monitored and appropriate management support must be provided until such time as a new permanent manager is appointed. The registered person must ensure that that external fire system checks are regularly undertaken and that records of these be maintained. DS0000007899.V307308.R01.S.doc Timescale for action 31/10/06 2 3. YA24 YA37 23 8 30/11/06 09/08/06 4. YA42 23 09/08/06 Red House Version 5.2 Page 22 5. *RQN 37 Future incidents affecting the 09/08/06 well-being of service users must be reported to the Commission for Social Care Inspection with evidence of what action has been taken to address the issue. 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 YA24 Good Practice Recommendations The wall in one service user ‘s bedroom should be redecorated. The water pipe covers in the kitchen and the ground floor bathroom should be replaced. The handle of the door linking the ground floor bathroom to one of the bedroom should be replaced. A minimum of 50 of care staff should be qualified to NVQ level 2 or above. Fire drills should be carried out every six months. Hot water outlets to full immersion facilities should be tested weekly. Hot water should be stored at a temperature that safeguards against Legionella (at a minimum of 60° Celsius). 2. 3. YA32 YA42 Red House DS0000007899.V307308.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 DS0000007899.V307308.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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