Inspection on 22/06/06 for Red House Nursing Home

This inspection was carried out on 22nd June 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 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 Nursing Home 02/11/05

Red House Nursing Home 12/05/05

Red House Nursing Home 18/11/04

Red House Nursing Home 04/08/04

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 Nursing Home 11 Emlyn Street Stamford Lincs PE9 1QP Lead Inspector Mr Toby Payne Key Unannounced Inspection 22nd June 2006 08:15 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 Nursing Home DS0000002638.V300415.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 Nursing Home DS0000002638.V300415.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Red House Nursing Home Address 11 Emlyn Street Stamford Lincs PE9 1QP 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) 01780 766261 Mr Dinesh Ambalal Patel Mrs Susan Miller Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Red House Nursing Home DS0000002638.V300415.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd November 2005 Brief Description of the Service: Red House Nursing Home is situated close the centre of the town of Stamford. The home is a three storey building with a two storey extension providing accommodation on ground and first floor levels. Rooms to the first floor are served by a shaft lift. The home is registered to provide care and accommodation for up to 23 people requiring nursing and personal care over 65 years of age. On the day of the inspection there were 20 people living in the home. The home is not on a bus route but there is limited car parking at the side and front of the home. There is a small patio area with a pond at the side of the home with access from the lounge/dining rooms. Most accommodation is single but the home provides 5 double bedrooms, which have en suite provision. The registered provider of the home visits the home every week and works closely with the manager. The fees at the inspection on the 22/6/2006 were £495 per week. Extras were for hairdressing which range from £1 to £7, chiropody £7, toiletries, personal newspapers and magazines. Red House Nursing Home DS0000002638.V300415.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and started at 8.15 am. It was undertaken using a review of all the information available to the inspector regarding our service history about Red House Nursing Home. This also included a pre-inspection questionnaire completed by the manager and 15 resident questionnaires sent to the home by the CSCI prior to this inspection. It took place over 5½ hours. The inspector spoke to 6 residents, 2 visitors, a visiting community psychiatric nurse, a nursing student on placement in the home 5 members of staff and the manager. The main method was called “case tracking”. This involved selecting one resident and tracking the care they received through the checking of records, discussion with them, the care staff and observation of how staff responded to their needs and that of the other residents What the service does well: What has improved since the last inspection? Five bedrooms have been redecorated and new toilets provided in 2 bedrooms. A hand rail has been fitted on the ground floor to enable more independence and safety for people in the home. Red House Nursing Home DS0000002638.V300415.R01.S.doc Version 5.2 Page 6 A new central heating boiler has been fitted to improve the heating in the home. 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 Nursing Home DS0000002638.V300415.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 Nursing Home DS0000002638.V300415.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Residents receive information to enable them to make a choice as to whether or not they wish to come to this home. Each person is admitted after a full needs assessment has been carried out by the manager. Red House Care Home meets the needs of residents coming into the home. EVIDENCE: There is a detailed statement of purpose and service user’s guide and a copy of the service user’s guide is given to each person when being admitted to the home. All residents are assessed before entering the home and written confirmation is sent to them that the home is able to meet their needs. Examination of a record of a recently admitted resident and discussion with this person confirmed this. All the 15 completed questionnaires also confirmed this. Red House Nursing Home DS0000002638.V300415.R01.S.doc Version 5.2 Page 9 Comments from a resident was, “the manager came to see me and arranged my transfer to the home where I received a very warm welcome”. The home does not provide intermediate care. Red House Nursing Home DS0000002638.V300415.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. There is good care planning in this home. The health and welfare needs of the people living in his home are fully met. Resident’s dignity is also met. EVIDENCE: A review of all information available prior to this inspection and a previous inspection carried out in November 2005 had evidenced that either the resident or their relative/advocate were involved in the care plans. All residents had detailed care plans, which described their health and welfare needs. The records included the resident’s agreement to their care plan with their signature, moving and handling assessment, risk assessments, dependency assessments and the care plan. There was evidence of dates of reviews. There were clear directions enabling staff to deliver the individual care to the residents. Care plans also showed evidence of promoting resident’s independence, respect, dignity and choice. Prior to the inspection, an issue was brought to CSCI attention in February 2006 concerning residents who had bed rails to protect them from harm and during the inspection care records Red House Nursing Home DS0000002638.V300415.R01.S.doc Version 5.2 Page 11 showed where this occurred risk assessments had been carried out and protective covers provided. It was also evidenced that there were 2 residents with pressure sores, each person had a specific care plan and were cared for on beds with alternating pressure mattresses. It also noted that none of the sores had occurred as a result of being in Red House. The inspector spoke to a visiting Community Psychiatric Nurse who was visiting a resident. The person had confidence in the home and commented that the staff accompanied the resident, explained about the reason why the person had come to the home and spoke in a quiet and kind manner. They nurse also spoke of the good communications and relationship between the home and their service. Where required, people living in the home are referred to GPs, Community Nurse, Community Psychiatric Nurse, Tissue Viability Nurse, Continence Nurse, Physiotherapist, Opticians, Dentist and Chiropodist. The home has Link Nurses who specialise in continence promotion and palliative care. They meet up with other nurses and promote up to date practice in consultation with the NHS Primary Care Trust. All medication is administered by registered nurses all of whom have been assessed as competent. Records showed that they were well maintained. Since the last inspection a new system for administering medication has been introduced and all staff responsible for the administration of medication have been trained. Residents commented that staff respected their privacy and dignity. The inspector could also see that staff knocked on doors before entering the resident’s bedrooms and spoke to them in a courteous manner. One resident commented, “when staff attend to me they always ensure that my dignity is preserved” and a questionnaire stated, “people listen to you here”. Red House Nursing Home DS0000002638.V300415.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Social activities are well managed with the involvement of residents. Residents receive good and nourishing meals. Visitors can visit whenever they wish to do so and are made to feel welcome. EVIDENCE: On admission details of the resident’s interests are obtained. The home employs an activities organiser. Activities are provided Monday, Tuesday and Wednesday. The home has a written programme of activities, which was displayed on a notice board at the entrance to the home. Activities included table games, craftwork, reminiscence, quizzes and gentle exercise. On admission, details of resident’s dietary likes and dislikes are obtained and this information is sent to the Kitchen. Residents were offered a choice of well-balanced and wholesome meals. Staff were seen to ask the residents what they wished to have for their lunch and approach them in a polite manner. They were also seen to assist those Red House Nursing Home DS0000002638.V300415.R01.S.doc Version 5.2 Page 13 residents who could not feed themselves in a patient, dignified and kind manner. At breakfast there is a choice including a hot meal, at lunch there is a set meal but an alternative is available if required and for tea there is a choice including a hot meal. At other times, snacks and beverages are available. Residents commented positively about the food. Comments from residents were, “I enjoy the food” and “I had a lovely lunch and the fish has been well cooked”. However from 15 questionnaires, 5 were always satisfied, 8 were usually satisfied and 3 were sometimes satisfied with the range of activities. Concerning meals, 10 always liked the meals and 5 usually liked the meals. Comments in the questionnaires were, “I would like more walking experience and exercises”, “it would be nice to be given a choice at meal times, not just what you are given” and “some of the meals I am not accustomed to”. The manager agreed to identify what resident’s want regarding the type and range of activities and meals by sending out the annual resident’s questionnaire in the future. The last Environmental Health Officer’s inspection was on the 29/3/2006. There were no concerns. Visitors commented, “when ever we visit we always receive a warm and welcome and are asked whether we would like a cup of tea”. Red House Nursing Home DS0000002638.V300415.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The home takes the issue of addressing complaints and ensuring that residents are safe very seriously and has a comprehensive complaints and adult protection procedure. EVIDENCE: Previous inspections of the home have shown that there is a detailed complaints procedure in place. Each resident receives a detailed complaints procedure when they are admitted to the home. No complaints have been received by the CSCI and home since the last inspection. The resident’s questionnaire showed that 13 were aware how to make a complaint and 2 who usually knew how to make a complaint. None of the residents or visitors had any complaints about the home and felt they could discuss any concerns with staff or the manager. Staff also knew what to do if they received a complaint from a resident. All staff receive adult protection training and staff knew what to do if adult abuse was suspected. Red House Nursing Home DS0000002638.V300415.R01.S.doc Version 5.2 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 and 26 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The home is well maintained, clean and attractively decorated. Furnishings are of a high standard and any maintenance required is attended to swiftly. Residents are also safe. EVIDENCE: A partial tour of the home by the inspector found it to be clean and smelt fresh. This was also confirmed from a previous inspection in November 2005. Residents said they liked their bedrooms and spoke of how satisfied they were with the cleanliness of the home. Red House Nursing Home DS0000002638.V300415.R01.S.doc Version 5.2 Page 16 There are 4 single bedrooms all on the first floor, which are below the minimum 10 square metre size requirements. These range from 8.44 to 9.60 square metres. This information has been included in both the statement of purpose and service user’s guide. Residents are encouraged to bring small items of furniture, pictures and personal mementoes into the home. They also commented positively about how much they enjoyed their bedrooms and how clean they were. Comments were, “”I have a lovely room and comfortable bed” and “my clothes are washed daily and returned”. Measures have been provided to ensure that residents are not scalded by being in contact with hot temperatures and surfaces. Previous inspections have found that the home had detailed and up to date maintenance records. A partial inspection of the home found that it was in a good state of repair both externally and internally. The home’s pre-inspection questionnaire gave evidence that various parts of the home had been redecorated. Red House Nursing Home DS0000002638.V300415.R01.S.doc Version 5.2 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): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. There is a well trained and competent staff team. The numbers of staff are sufficient for the numbers of residents. Staff are correctly recruited and there is a very well established team. EVIDENCE: A review of all information available prior to this inspection showed that staff were correctly recruited. Staff files examined of a member of staff who had been recently recruited showed they had been recruited correctly with checks by the Criminal Records Bureau. Care workers were also given a copy of the General Social Care Council’s Codes of Practice, which sets out their responsibilities as care workers looking after vulnerable adults. The home’s pre-inspection questionnaire showed that 50 of staff have obtained qualifications in care (National Vocational Qualifications). Two of the staff have achieved level 3. A further 4 care staff were studying level 2, one level 3 and a further person level 4 for these qualifications. All staff receive an appraisal annually. There is an extensive training programme for staff, which includes training in care, internal lectures and training from outside trainers. Future training will include stroke awareness and moving and handling Red House Nursing Home DS0000002638.V300415.R01.S.doc Version 5.2 Page 18 The home also provides training for nursing students. A nursing student on her first placement commented, “Brilliant, “I have been mentored and supported throughout”. The home received an Investor’s in People award for its commitment to the education and development of staff. Residents did not express any worries about the level or availability of staff. During the inspection staff were seen to promptly attend to residents needs. Staff also felt they had sufficient time to care and support the residents. Comments were, “I have worked here for many years, yes, we are busy but we can cope” and “we do a lot of training”. On the afternoon of the inspection there was to be a training session on the safe moving and handling of people. Red House Nursing Home DS0000002638.V300415.R01.S.doc Version 5.2 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 and 38 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Red House is managed properly by a competent and experienced nurse. There is leadership, guidance and direction. This allows the staff to ensure residents receive consistent quality of care. EVIDENCE: The manager was registered by the CSCI in February 2006. The manager is a registered nurse with extensive nursing, education and management experience. She and her deputy are studying for a management qualification. Residents, visitors and staff were positive about the staff team throughout the inspection. Comments from residents were, “everyone has been so friendly and the staff are so kind”, “if you don’t like this home there is something Red House Nursing Home DS0000002638.V300415.R01.S.doc Version 5.2 Page 20 wrong with you, I find the staff so kind”, “you cannot get better than this” and “I am very satisfied. Staff comments were “we all work together”, “there is plenty of training” and “we have regular staff meetings”. Residents/relative questionnaires stated, “we are pleased with the care given inn this home and the cheerful attitudes of all the staff at all times” and “I cannot speak too highly of them, wonderful care”. There were noted to be cards and letters on the ground floor office door thanking staff for the care they had shown. The manager on request handle resident’s monies. Where this takes place detailed records are kept together with receipts and signatures. Records examined showed they were well maintained and kept securely. Staff receive annual appraisals and care staff and nurses formal supervision. The last resident and visitor’s annual questionnaire was sent out in March 2005. There were very positive responses received. The manager agreed to send out the annual survey for 2006 and request residents views and opinions about the variety of food and activities provided as a number of residents in the comment cards had raised concerns about these. The manager carried out a very detailed internal audit of the home’s 38 quality standards in March 2005 and agreed to carry this out in the future. Red House has comprehensive policies and procedures including clinical procedures. There is an equal opportunities policy and the manager agreed to expand the information to include issues of equality and diversity. The home also had detailed health and safety policies including risk assessment. Records showed that essential equipment had been regularly serviced. Records were well maintained, up to date and available. Red House Nursing Home DS0000002638.V300415.R01.S.doc Version 5.2 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 3 x 3 x x N/A 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 3 x x x x x 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 4 3 x 3 x x 3 Red House Nursing Home DS0000002638.V300415.R01.S.doc Version 5.2 Page 22 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. 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. Refer to Standard Good Practice Recommendations Red House Nursing Home DS0000002638.V300415.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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. 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