Inspection on 14/11/06 for Red House (The)

This inspection was carried out on 14th November 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 (The) 29/11/07

Red House (The) 01/11/05

Red House (The) 31/05/05

Red House (The) 11/01/05

Red House (The) 05/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Red House (The) 43 Skinners Lane Ashtead Surrey KT21 2NN Lead Inspector Kenneth Dunn Unannounced Inspection 14th November 2006 10:00 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 (The) DS0000013362.V320285.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 (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Red House (The) Address 43 Skinners Lane Ashtead Surrey KT21 2NN 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) 01372 274552 01372 277880 The Red House (Ashtead) Limited Mrs Margaret Mary Josephine Chu Care Home 25 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (23) of places Red House (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Of the 25 service users, up to 23 may be service users requiring nursing care Of the 23 service users receiving Nursing Care, 1 may fall within the category DE(E) The age range of residents within categories OP or DE(E) is 60 YEARS AND OVER For seven days of the week there must be 2 registered nurses on duty for the morning shift Of the 2 service users receiving personal care, only 1 may fall within the category DE(E) 1st November 2005 Date of last inspection Brief Description of the Service: The Red House is a large, detached house, situated in a quiet residential area, close to the village of Ashtead. The home provides nursing care for up to twenty five people, of which up to two may have a diagnosis of dementia. Accomodation is on two floors with access to the first floor by a passenger lift. There are two dining ares, and a lounge with a spacious conservatory area. There are very attractive and well maintained gardens, which are easily accessible to the service users. Red House (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was the first to be undertaken in the Commission for Social Care Inspection year 2006 to 2007. The inspection was carried out by Mr Kenneth Dunn, Regulation Inspector and Mrs. Margaret Chu, the registered manager for The Red House. A tour of the premises was undertaken and service users, visitor and members of staff were spoken to. A number of records and documents were examined, including care plans, staff personnel files, medication administration records and policies and procedures. The inspector made 3 requirements during the course of this inspection; all 3 were actioned and met prior to the end of the inspection day. The Commission would like to thank the staff, service users and visitors for their hospitality and cooperation throughout the inspection process. What the service does well: What has improved since the last inspection? The home has met the requirements identified in the previous CSCI (commission for social care) inspection report for the period 2005 & 2006. 2006. Red House (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 6 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 (The) DS0000013362.V320285.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 (The) DS0000013362.V320285.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for the assessment of needs are good ensuring service users’ needs are assessed before admission to the home. EVIDENCE: The manager stated service users are admitted to the home on the basis of an assessment of needs and the home had an assessment and admissions policy. The inspector sampled records and noted the home had an initial assessment form which is used to assess service users’ needs and covered the areas of personal care, social support and healthcare needs. Further evidence indicated staff working at the home had training in psychiatric nursing, dementia awareness, NVQ (National Vocational Qualification) in care, promotion of continence and collectively have the skills and experience to meet the needs of service users The service users receiving intermediate care are clearly assessed for the sole purpose of rehabilitation and their planned return to their own homes. At the time of this inspection only one service users was receiving intermediate care. Red House (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 9 An audit of the service users file clearly indicated that all necessary documentation was completed and reviewed regularly to record their progress and eventual return home. Red House (The) DS0000013362.V320285.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning at the home is thorough ensuring service users individual care plans reflect their specific needs. The systems for accessing healthcare ensure service users healthcare needs are assessed and met. The arrangements for privacy and dignity are upheld. The management of medications at the home promotes good health. EVIDENCE: The manager stated service users have individual care plans, which are drawn up following an assessment of needs. The inspector noted that the home had care plans, which sets out in details actions to be taken with regards to personal, social and health care needs. The manager stated service users have named key workers and care plans are regularly reviewed and updated to reflect service users changing needs. The inspector sampled care plans, which were regularly reviewed, dated and signed by key workers. The manager stated service users have access to healthcare professionals to meet their needs and the inspector noted service users are registered with local GP’s. The manager remarked the home had a policy on medications and only qualified Red House (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 11 nurses or senior care workers administer medications to the service users. Medication record sheets were dated and signed by staff and a list of staff specimen signatures was available for information. However the inspector noted an error in the recording of medication given by staff, signatures where missing on the MAR sheets. The manager stated the home had a policy on privacy and dignity and the inspector noted the home had information on the GSCC (general social care council) code of conduct for care staff. Observations confirmed staff addressed service users by their preferred names and the manager knocking on doors before entering service users’ bedrooms. Service user feedback strongly indicated that the majority of service users were very happy with the care they received at The Red House, one comment received stated that the ‘‘nursing care is first class’’. Red House (The) DS0000013362.V320285.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for activities are good ensuring service users social and cultural interests are catered for by the home. The systems for family contact are designed to ensure service users maintain links with family and friends, as they would wish. The opportunities for exercising choice are well developed ensuring service users can exercise choice over their lives. Meals at the home are well balanced and offer variety and choice. EVIDENCE: The home has a robust policy for social contact and activities and the inspector noted service users have the opportunity to exercise choice in relation to leisure, social activities and cultural interests. The home employees an activities co-ordinator and a comment from a service user received by the CSCI stated that ‘‘I enjoy the activities here and everybody is helpful’’. The activity coordinator designs a monthly activities programme, which included many interesting topics i.e. music, quiz’s and crosswords. The home also ensures that the service users can participate in all celebrations and festivals, the home recently held a service of thanks giving for Armistice Day. Church services are regularly held and the local vicar ensures the service users can receive communion in the home. Red House (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 13 The home values equality and diversity and encourage service users to participate in community life. A review of records indicated service users had contact with family and friends and the home had a flexible visitor’s policy to promote links with relatives. The inspector discussed a specific situation where family members were making demands upon the service in respect of their perceived rights and not the wishes of the service user. In this case there was significant confusion over the contact details and the official next of kin. The manager must ensure that a policy is in place to protect the service users in the first instance and wherever possible the service user must be fully apprised of the situation to allow them to make the final decision if possible. The manager remarked the home had written menu plans and staff commented service users participated in planning the menu. Mealtime were describe by one service user as being “relaxed and unhurried and meals were nicely presented”. Further feedback from the service user stated was that ‘‘the food is very good, we get seasonal produce’’ and another commented ‘‘food is quite good, if you can’t eat something you get something else’’. Red House (The) DS0000013362.V320285.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The policies and procedures for complaint handling and processing is very robust, the complaints policy is readily available to service users their relatives and members of the staff team. The arrangements for adult protection has bee fully strengthened all staff have accessed the local authority training on safeguarding adults and the protection of service users from harm and abuse. EVIDENCE: Red House (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 15 The manager stated the home had a complaints policy, which is available in the policies and procedures file and the inspector noted complaints information in the service users guide. The manager stated the home had a complaints folder, which was sampled, and no complaints were recorded. During discussions a staff stated she was ‘‘aware of the complaints procedure’’ and a service user remarked ‘‘Generally, I am happy with things. I have no reason to complain’’. In conjunction to standard 13 & 17 of the National Minimum Standards the legal rights of the service users must be pre-eminent in the policies, procedures and actions of the staff and management of the home, a policy must be developed to ensure that where a service user can give a legal statement this must always be sought prior to gaining impute from any other interested parties. The home had a policy on safeguarding adults and an up to date copy of the local authority (Surrey County Council) procedures on the protection of vulnerable adults. The inspector noted no concerns or allegations in respect of safeguarding adults were raised since the last inspection by the CSCI (Commission for Social Care Inspection) and confirmed by the manager. A review of records indicated staff ha e now all attend training in safeguarding adults following a requirement made in the previous inspection report. Service user and family feedback indicated that the majority of service users feel that they are supported by the staff and that “they are helpful, very good, nothing is too much for them.’’ Red House (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The generally the premises are good ensuring service users live in a safe and comfortable environment. The systems for hygiene control are well established and over all the home is clean and hygienic. EVIDENCE: Red House (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 17 The Red House is well maintained and the garden is tidy, attractive and accessible to service users. The home has a programme of maintenance and the provider stated there are plans to extend the home and improve the quality of accommodation for service users. On the day of the inspection the home was clean and apart from one localised area was free from mal odour. In one area a strong smell of urine was identified the manager explained that one of the service users had had been incontinent and as a result the carpet had been ruined even after several shampoos. The manager however contacted a local carpet supplier on the day of the inspection and the highlighted area will be replaced. The home has a good set of policies and procedures for the control of infection and all staff have had infection control training this is reflected in their individual training records. Observations confirmed the staff practiced infection control measures by using gloves, aprons and washing their hands regularly to prevent the spread of infection in the home. Red House (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staffing arrangements ensure that there are sufficient numbers of staff to meet the needs of service users. The staff teams training requirements are very good. The systems for recruitment of staff are satisfactory protecting service users from harm or abuse. Induction training ensures staff are trained and competent to do their jobs. EVIDENCE: On the day of the inspection the home was adequately staffed the registered manager, six nurses/carers and a cook were on duty, which was reflected on the duty roster. Service users feed back forms reinforced this and one stated that ‘‘staffing levels at the home are good’’. A service user remarked ‘‘ I am very well looked after here, thank you’’ and a relative commented ‘‘all staff are caring, kind and cheerful”. A review of records indicated that 75 of the staff has gained a NVQ level 2 or 3 in care. A relative commented ‘‘I have always been satisfied with the standard of caring in the home, staff always helpful’’. The home policy on recruitment is designed to ensure that the service users are safeguarded at all times. The manager stated the home had an induction checklist and staff working at the home have induction training, which covered the values and principles of care, policies and procedures, health and safety and was dated and signed by the supervisor and employee. One member of staff gave feedback stating that the ‘‘manager is very good and committed to staff training and development’’. Red House (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 19 Red House (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The arrangements for the day-to-day management of the home are sound ensuring service users live in a home, which is run and managed to meet their needs. The home has a good quality assurance procedure. The arrangements for safe working practices need strengthening to safeguard the welfare of staff and service users. EVIDENCE: The home has a registered manager who provides management stability, leadership and direction to the staff team. The manager has a professional nursing qualification, the RMA (Registered Managers Award) and the NVQ level 4 in management and has over 38 years experience in the care. The inspector noted there are clear lines of accountability in the home and the manager is aware of her role and responsibilities. A relative commented ‘‘The Red House Red House (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 21 is Superb, it is more like a hotel than a home for residents with health problems’’. The home has a good policy for ascertaining the service it provides the service users. The quality assurance surveys and a review of records indicated the home had discussions with staff, service users and families to obtain feedback about the home. The home had a health and safety policy and staff have training in health and safety, first aid, food hygiene, infection control and moving and handling. All health and safety checks were completed on behalf of the service March 2006. In addition the manger also completed an internal health and safety audit of the home the completed document was signed 24/04/06. The home had a policy on COSHH (control of substances hazardous to health) and observations confirmed COSHH products were stored in a locked cupboard and the home had data sheets to promote the health and safety of staff and service users. Red House (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Red House (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 23 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. OP13 OP17 Standard Regulation 12(4a), 16(2m) & 23(2i) Requirement The manager must ensure that all service users are given the right to contact from family members or friends, unless where a recognised restriction is in place. Met on the 14th of November 2006. The manager must ensure that all staff sign that medication is given at the time of dispensing. Met on the 14th of November 2006. The manager must ensure that all areas of the home are kept free from mal odours. Met on the 14th of November 2006. Timescale for action 14/12/06 2. OP9 13, Schedule 3.3 (q) 13, 16 & 23 14/12/06 3. OP26 14/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Red House (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 24 Red House (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 (The) DS0000013362.V320285.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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