Inspection on 06/03/06 for Red House Residential Home

This inspection was carried out on 6th March 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 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 Residential Home 21/07/08

Red House Residential Home 31/07/07

Red House Residential Home 07/08/06

Red House Residential Home 07/07/05

Red House Residential Home 17/02/05

Red House Residential Home 02/10/04

Red House Residential Home 24/03/04

Red House Residential Home 05/11/03

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Red House Residential Home Meadow Lane Sudbury Suffolk CO10 2TD Lead Inspector Mary Jeffries Unannounced Inspection 6th March 2006 11:30 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 Residential Home DS0000024477.V287080.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 Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Red House Residential Home Address Meadow Lane Sudbury Suffolk CO10 2TD 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) 01787 372948 01787 377528 dgs@rhwhs.fsnet.co.uk The Red House Welfare and Housing Society Mrs Heather Jean Choat Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th July 2005 Brief Description of the Service: The Red House is registered as a care home for 34 older people. The Red House Welfare and Housing Society was founded after the Second World War by a group of local religious, civic and business people on a non-profit making basis, to provide communal accommodation to meet the needs of older people. The home was opened in 1950 and has been extended over the years. The original house is 18th century and set in its own gardens enclosed by an unusual ‘crinkle-crankle’ brick wall. The grounds are very well maintained and provide a pleasant and substantial area for residents to take short walks. The home is sited very close to the centre of Sudbury and there is a range of local facilities within walking distance for the more able. Bedroom sizes vary although all are designed for single occupancy. Within the home there are three ‘flatlets’. One of these, formerly known as the Matron’s Flat, is not currently occupied, pending a decision as to whether to convert this area into two rooms and apply for a variation for one more person. Communal space is located on the ground floor and there is a shaft lift to carry residents to the first floor. Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted over the mid day period one Monday in March 2006 and took three hours. It was facilitated by the Registered Manager. Three individual residents and a group of four were spoken with, three were tracked.Two carers and the cook participated in the inspection; they were helpful and showed real interest in their work. The home had three vacancies on the day of the inspection. What the service does well: What has improved since the last inspection? What they could do better: The home needs to ensure that health and safety systems are monitored and maintained. The home must produce an induction programme that meets the social care industry standard. Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 6 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 Residential Home DS0000024477.V287080.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 Residential Home DS0000024477.V287080.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): 1,6 Potential residents do not currently have good access to all the information they should to make an informed judgement about moving to this home. EVIDENCE: Standards 3 and 5 were found to be met at the last inspection. The home has not yet provided a copy of a Service User’s Guide which contains the information required by regulation, or the information recommended under the standard. Prior to the inspection the home advised in writing that this would be available by 30th April 2006. The Registered Manager confirmed that the home does not provide intermediate treatment. Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 9 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): 9, 10 Residents can expect to be treated with dignity and respect and for their privacy to be upheld. EVIDENCE: Standards 7,8, and 11 were found to be met at the last inspection. Standard 9 was also fully inspected at the last inspection, and two requirements made. One of these was found on this occasion to be met, records were maintained for medicinal creams administered by carers. The other requirement was found not to be fully met: there was no risk assessment in place a resident who self medicates. Medication administration record sheets, (MAR)s, were generally good, with no unexplained omissions. Where a tablet was prescribed for one or two to be given, the dosage administered was sometimes but not always recorded. Two seniors were responsible for stock taking, and a returns book was maintained. Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 10 The home had arranged for a person, who was previously a carer at the home, to do sewing in the laundry, and the manager advised that they were now ordering clothing labels before residents were admitted, which were sewn into residents clothes when they arrived. A resident spoken with advised that they had not been at the home long, but that they had had no problems with the laundry. Three residents spoken with individually and a group of four residents spoken with all spoke very highly of the carers and the managers attitude, and felt that they were treated with respect and that their privacy was upheld. Staff were spoken with about the care of a resident with MRSA, which was dealt with discretely. Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 11 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 Residents can expect to have access to a good range of activities. They can expect to live in a home where the atmosphere is conducive to them choosing to develop a lifestyle that suits them, be that focused on individual activities, friendship groups, friends and family, or the routine and activities provided by the home, or a mixture of these. EVIDENCE: Standards 12, 13, 14,15 were found to be met at the last inspection. It was, however, recommended that the activities provision be reviewed. The Registered Manager advised that the home was providing regular bingo and regular music and movement sessions, alongside its programme of outings and activities. Notices in the home advertised bingo taking place on Thursday mornings, and music and movement on Wednesday afternoons. A reminiscence session was advertised for the 23rd March, as was a schedule of monthly live music sessions. A number of annual events had been put in the home’s diary, including a garden party, a day trip to Finchingfield and the Christmas party. A monthly programme of church services, provided by three different churches was also posted. The home has a home library service. Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 12 A list of activities was up on the wall of the lobby to the lounge. A resident spoken with said that they there was enough going on, but added that they had a big family, and lots of visitors. They confirmed that these are always made to feel welcome. Another said that there was not much going on, and they felt that they should get reminders from staff going round as not everyone read the notice board. They said that they see the notice but “it goes out of my head”. The Registered Manager advised that they do go round in the day of an activity telling everyone if something is on. A resident who is deaf said that they chose not to join in the social events, but that they had their group of mates and that they had some of their hobby equipment at the home; they explained that they were moving to a room with better light, as they enjoyed crosswords. Residents had individual relationships and friendships within the home. A group spoken with spoke of relying on others for particular strengths. One said it’s the same as in a big family, some you get on with, and some you don’t. The home had maintained a record of activities attended which showed that in February 15 had attended the clothes sale party, 4 had attended a massage and relaxation session, 13 had attended the external singers event, and 8 had played bingo. Staff spoken with felt that the home was improving all the time, and that the social side had built up. Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 13 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 The home has an open atmosphere and residents are well satisfied, however residents can expect to feel confident that they can take any concerns to the manager and for them to be dealt with appropriately. EVIDENCE: Standard 16 was found to be met at the last inspection. No complaints had been entered in the log since then, and no complaints had been received by the CSCI. A resident spoken with said that if they were unhappy with anything that they would go to see someone in authority, but said that they didn’t think anyone had anything to complain about, they went onto say that the women (the carers), were all kind, and that they couldn’t fault any of them. The complaints notice on the notice board advised residents that if they were not satisfied with the treatment of a complaint that had put to CSCI, then they could complain to the Director of Social Services; this is not correct. Evidence was seen that the Registered Manager had received training in the protection of vulnerable adults in 2004, advised that “quite a few staff “ had received training in the Protection of Vulnerable Adults. Staff spoken with confirmed that they had had training, and advised that they would report any concerns about suspected abuse to the manager immediately. They advised that “she is the sort of manager you can discuss anything with”, and were confident that she would respond appropriately. Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 14 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, 25, 26 The home is attractive, clean and well maintained. EVIDENCE: Standards 20, 21,23,24 and 26 were found to be met at the last inspection. The home was found to be attractive and homely. The programme of covering radiators on a risk assessed basis is not yet complete. The Registered Manager advised all bedrooms had been done. Upgrading had occurred in the homes kitchen. The gardens were seen to be in very good order. A resident spoken with advised that markings had been put onto the small rise in the floor level just inside the dining room door, to ensure residents notice it, and this was found to be the case. All kitchen staff wore hats and aprons. The home was clean and free from odour. Toilets checked were clean and had liquid soap and paper towels. Staff advised that they had fairly recently started to have use Gel available, for hand cleaning purposes. The home’s control of infection policy did not refer to this. Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 15 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): 30 Residents cannot assume that any new care staff or kitchen staff will have had appropriate training. Residents can expect to be cared for by an experienced committed staff team who enjoy their work and are genuinely concerned for them. EVIDENCE: Standards 27, 28 and 29 were found to be met at the last inspection. The manager advised that no new staff had been recruited since the last inspection. The home was adequately staffed on the day of the inspection. Two staff spoken with confirmed that they had received fire training, first aid and manual handling updates. Records indicated that 16 staff had received first aid training and that 12 staff had received fire safety awareness training in February 2006. Manual handling updates had also taken place. It was found at the previous inspection that seven staff had not had induction. This had been planned for the Autumn, and records showed this had been carried out, however, it was not established that this met ToPSS standards. The Registered Manager advised that the home was still working on developing the induction programme, and that it now had to meet Skills for care standards. Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 16 At the previous inspection, the home had 33 percent of carers with NVQ2. Four staff had commenced NVQ2 since then, but two had dropped out. The manager had planned for others to commence. The home has a stable staff group, who are very experienced. At this inspection and previous inspections they have been consistently spoken well of by residents who have described them as very caring. A resident who was spoken with at the last two inspections had moved to a nursing home, and staff spoken with were aware of how they had settled in, and advised that they and the Registered Manager had visited to see them settled. This resident had moved to Kent. Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 17 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): 33,38 Residents satisfaction was generally very high, supporting a view that the home is run in the best interests of the residents, however, the benefit of a service user survey in ensuring the home remains alert to residents current concerns, and in informing planning, are likely to be diminished if the results are not available in a timely way. Residents may find that health and safety controls lapse at times. EVIDENCE: Standards 31,35,36, and 37 were found to be met at the last inspection. The manager advised that they had recently passed their combination level 4 training and were awaiting the certificate. The Registered Manager advised that they had recently conducted a service user survey, that extended to relatives, but that they had used the piece of Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 18 work for their NVQ award and it was not available. They advised that the results would be published in the Service User’s Guide. Within the lobby to the lounge there is a private post box for residents use, and one resident who was wheelchair bound advised that they found this very useful. The Environmental Health Department had visited the home on 30th January 2006 and had made a number of requirements and recommendations. The home was required to provide a documented food safety management system and ensure all relevant staff are fully trained in its implementation, which includes formal systems to control: 1.Staff training in food hygiene, including awareness training for new employees, 2. Staff sickness reporting 3. Food cooling The manager provided a letter stating the progress the home had made on these issues. This advised that training was being organised, that reminders if the need to be free of sickness and/ or diarrhoea symptoms for 48 hours before returning to work would be included in induction procedures, and that both cooks were aware of the need to refrigerate food as quickly as possible. The letter did not refer to the progress on the food management safety system, however the a cook was spoken with and they advised that they had attended a seminar on Safer Food run by the District Council, and they had obtained the pack that would assist them with producing the required written system. The cook showed the pack to the inspector, and advised that they were working their way through it, but did not have a Critical Control Point Hazard Analysis (HACCP) yet. Two other requirements made by Environmental Heath had been met, one of these, the need to monitor insect ingress through open windows in the kitchen required on going monitoring. Environmental Health made three recommendations, the need to check probe thermometers for accuracy, to ensure fridges containing high risk foods ran at 5 °C, rather than 8°C, as had been the case with one, and to maintain records of cold storage and cooking temperatures. The Registered Manager advised that the lapse in temperature recording had been rectified. This was checked at this inspection and found to be the case. The cook was able to advise how they would check the accuracy of the probe thermometer. The homes control of infection policy did not refer to the use of hand gel, which is available in the home. Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 19 The fire escape was checked and found to be free from obstructions. The boundary of the roof forming part of the fire escape route from the top flat had been made good. The flat roof was mossy, but there is no one living in the top flat at present. A group of residents spoken with were asked about the fire alarm. One confirmed that they heard it tested regularly. The home’s Certificate of Registration and public liability insurance were displayed. The home/s last inspection report was on display. Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 20 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 ENVIRONMENT CHOICE OF HOME Standard No Score 1 2 3 4 5 6 Standard No 19 20 21 22 23 24 25 26 Score 2 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X 3 3 STAFFING Standard No Score 27 X 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X X 2 Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 21 YES 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 OP1 Regulation 5 Requirement The Registered Persons must forward a copy of a Service User Guide which meets the regulation. This repeat requirement is within the revised timescale. Risk assessments must be in place for all residents who self medicate. This is a repeat requirement. Timescale for action 30/04/06 2. OP9 13(4)(b) 14/04/06 3. OP9 13(4)(c) 4. OP16 22(3) 5. OP30 18(1) (c)(i) Where a variable dose of 30/04/06 medication is prescribed, the amount administered must always be recorded. The complaints notice on display 14/04/06 must be corrected, to reflect that CSCI is independent of Social Care Services. The homes must have 30/06/06 foundation and induction training programmes which comply with standards. A copy of the training programmes must be forwarded to CSCI. This is a repeat requirement from the last two inspections. Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 22 6. OP30 18(1)(c) (ii) The Registered Persons must ensure that all kitchen staff have appropriate food handling training. This is a repeat requirement. The homes control of infection policy must include reference to the use of gel for hand cleansing and of its limitations. The home must have a food safety management system based on the principals of HACCP. 30/06/06 8. OP38 13(3) 30/04/06 9. OP38 13(4) (a)(c) 31/07/06 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. 2. Refer to Standard OP30 OP33 Good Practice Recommendations The percentage pf staff with NVQ 2 or above should be developed. A service user survey had been carried out at the end of September 2004. The results of this should be disseminated, and future surveys used whilst they are still contemporary to influence development planning for the home. Red House Residential Home DS0000024477.V287080.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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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