Inspection on 19/06/05 for Red House, The

This inspection was carried out on 19th June 2005.

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, The 22/07/08

Red House, The 23/08/07

Red House, The 11/05/06

Red House, The 27/10/05

Red House, The 06/09/04

Red House, The 26/04/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE THE RED HOUSE 423 West Green Road Tottenham London N15 3PJ Lead Inspector Karen Malcolm Unannounced 19th, 26th May & 1st June 2005 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 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. THE RED HOUSE Version 1.10 Page 3 SERVICE INFORMATION Name of service The Red House Address 423 West Green Road, Tottenham, London, N15 3PJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8889 0097 020 8888 0311 Monica.Burke-Newton@haringey.gov.uk Mary Hennigan of London Borough of Haringey Mrs Monica Burke-Newton PC - Care Home 35 beds Category(ies) of DE - Dementia - over 65 registration, with number OP - Old age of places THE RED HOUSE Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 8 of the 35 persons may have a diagnosed dementia (DE (E)). 2. These persons who are in the category DE (E) must be accommodated in the living unit identified for this purpose. 3. The home may provide accommodation and personal care for up to 35 persons of either gender who are over 65 years of age (OP). Date of last inspection 6 September 2004 Brief Description of the Service: The Red House is a purpose built home located in the West Green area of Tottenham. The home is close to local shopping and transport facilities, and a short distance from the shopping and entertainment facilities of Wood Green. The home is provided and managed by the London Borough of Haringey Social Services Department with the aim being to provide care with dignity for up to 35 people who are elderly. The home is arranged over two floors, with two units on each floor. Each unit has its own lounge and kitchenette, and there is also a large communal lounge located on the ground floor. Some service users have additional physical disabilities and mental health needs associated with ageing. In addition to providing care for its residents, the home recognises the importance of appropriate stimulation through the employment of a full time activity co-ordinator. THE RED HOUSE Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was competed over three days. Angela Hunt Regulation Manager accompanied the lead inspector on the second day and CSCI pharmacist Marilyn Mackenzie completed an inspection on the third day with regards to the medication policy and procedure. The manager assisted the inspectors and the pharmacist throughout, the inspection, which was open, positive and informative. The inspector would like to acknowledge the assistance of the registered manager and the staff on duty in the conduct of this inspection. The manager informed the inspector on day one of the inspection that she had recently returned back to work. The Commission was aware of this prior to the inspection. In the home at the time of the inspection were thirty-two service users, the manager, a senior carer, a domestic assistant, two activity workers, the laundry assistant, the cook and seven care staff. During the first day of the inspection one of the care staff’s NVQ assessor visited and service users participated in a morning activity supported by two activity workers. The main focus of this inspection was to check whether improvements had been achieved with regards to the requirements from the previous inspection. The inspection involved the inspector speaking to a number of service users, who were happy with the service they received and examining service users’ care plan, record, medication policies and procedures and a tour of building. The second day consisted of a thorough tour of the building with regards to the general maintenance and up-keep of the home. What the service does well: What has improved since the last inspection? At the previous inspection there were seven areas for improvement three of which have been met. Four areas of improvement have been restated. These THE RED HOUSE Version 1.10 Page 6 relate to on-going issues with regards to the refurbishment. The inspector has required the registered person to the home following areas: • The refurbishment for the kitchenettes within all the units • All the communal areas carpets to be replaced • All the bathrooms and toilets to be refurnished and redecorated • To preview the staffing levels within the home • To provide a detailed summary of the all the service users needs within the home in order that on assessment may be may be made in relation to the staffing levels needed. A letter was submitted to the Commission prior to this report being completed and a meeting has been arranged with the registered persons on the 22nd June 2005 to further discuss the needs of the service users and current staffing level in the home. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. THE RED HOUSE Version 1.10 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 Standards Statutory Requirements Identified During the Inspection THE RED HOUSE Version 1.10 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 standard(s) 3 & 4 The home has failed to ensure that service users needs are appropriately assessed prior to moving into the home. Therefore service users cannot be convinced that their needs will be appropriately met once they move in. EVIDENCE: At the previous inspection it was required that the registered person informs the CSCI of the outcomes of the specific service user’s latest assessment with regards to the service user’s needs. The manager informed the inspector that this service user had since died and the service user’s care plan notes have now been archived. The Red House is separated into four units, Beech, Willow, Cedar and Maple. The home’s Conditions of Registration is for thirty-five older people, eight of which may have a diagnosis of dementia. There is an additional Condition for two service users diagnosed with dementia to reside in a non-dementia unit until such time as a vacancy comes up in the home’s dementia unit. In addition, there area an additional three service users which a diagnosis of dementia for which the home is not registered to admit. At present the home has three vacancies and since the previous inspection two service users have moved. THE RED HOUSE Version 1.10 Page 9 A number of care plans were sampled from each of the units. It was evident that assessment prior to service users moving into the home had not been fully completed. It was noted on a number of service users care plans sampled that the main reason for an individual’s care was a diagnosis of dementia. These service users resided in one of the other units in the home, other that the unit allocated for service users with dementia. This was discussed at great length with the manager and one of the senior support staff. It was advised that a letter would be written to the registered person regarding a request for a comprehensive details to be submitted to the CSCI no later than the 15th June 2005. This is to include the units the service users reside in, client category, and details of each service user’s level of need (i.e. what level of assistance is required in relation to personal care). During the tour of the building on the first day with the manager, one service user had their bedroom door wedged opened. The issue of all fire doors being kept shut was discussed. However, the manager stated this specific service user does not like their bedroom door kept shut. It was advised that the service users risk assessment should reflect this, and a magnetic door closure should be in place on this specific door if the service user wished for their bedroom door to be kept open at all times. It was also advised that the home’s admission assessment should be amended to include a section on individual’s likes and dislikes and day and night–time routines. THE RED HOUSE Version 1.10 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 standard(s) 7, 8, 9 & 10 The home has failed to record and monitor consistently service users health, personal and social needs. Therefore not ensuring that the appropriate support and care needs are followed by care staff supporting service users in the home. The home has failed to ensure medication policies and procedures are correctly followed and monitored, therefore placing service users at risk and harm. The home has failed to ensure that service users at are at all times treated with the respect and dignity they deserve. EVIDENCE: Care plans are kept on each unit, however, it was found that the care plans were not kept securely. The cupboards used to store the care plans were found to be falling apart and in some units the care plans were kept in a file box on a shelf. The assessment parts of individual’s care plans were kept in the main office on the individual’s main file. On examining these it was evident that in place was an index list outlining to what information should be kept on file. However, this was not reflected in the information found on each file examined. Information with regards to individual’s health, personal, social and care needs were in place but not consistently kept up-to-date by care staff. For example one service users care plan stated that a number of bruises were found on the THE RED HOUSE Version 1.10 Page 11 service users body, but no follow-up information that was unfamiliar with this incident and was recorded upon further enquiry at the time of the inspection. The manager was unable to confirm what action had been taken. Another service user care plan stated that this service user wanders from time to time, no updated information regarding the support given by care staff was recorded. A third service users Zimmer frame was broken and, waiting repair. This was reported to the senior support staff, and the home was waiting for the physiotherapist to reassess the service user. However, in the meantime there was no information recorded on the individual’s care plan on how the home is supporting this specific service user to mobilize. The service users care needs meant that they became confused and anxious with regard to their mobility It was evident that monthly reviews, risk assessments and daily records were not completed consistently. This was addressed with the manager during the feedback session at the end of the inspection. During the tour of the building on the first day staff interaction with service users was observed. This was not always positive. For example one service user asked a care staff for assistance with a bath. The reply given by the member of staff was that the service user was clean as the service user had a bath on Sunday. The day this comment was heard on Thursday. It was also observed that staff were not able to give their full attention to all the service users in each of the units due to the ratio of staff to service users. For example on one unit there were 9 service users to 1 member of staff. Care staff spoken to state that it was sometimes difficult to ensure all care needs are addressed fully, because of the number of service users within the unit. Upon asking a number of care staff their roles and responsibilities, it was not clear whether staff knew their roles and responsibilities, as the response given by different staff was confusing and unclear. The home’s culture was ‘I’ve reported it to the seniors’. This was discussed with the manager and senior support worker during the feedback session. The inspector was informed that the GP visits the home every Tuesday and Thursday. The optician and dentist also visit, records of this kept in diary a in the main office. On the first day the inspector observed one of the senior care staff administering medication. A number of issues were raised: • The senior staff administering medication did not wash her hands prior to administering medication. • Chlorophenciol eye ointment was kept in the trolley and not in the fridge • No guidelines in place for PRN medication • Medication at lunchtime could have been given after lunch as a number of users refused their medication during this period. On the third day the CSCI pharmacist inspector observed that the home has a medicines policy except it did not deal with THE RED HOUSE Version 1.10 Page 12 • • • • the receipt of medication the possibility of covert administration the possibility of service users wishing to administer their own medication. retaining medication for a period of seven days in the event of the death of a service user in case there is a coroner’s inquest. The assistant manager stated that their service users were too frail to administer their own medication. The records for the receipt, administration and disposal of medication were satisfactory. The records stated that if a service user was asleep when the medication round was taking place they did not receive their medication. Some of this medication was essential to their physical wellbeing and should have been given to the service users at a more suitable time for them. Some of medication histories were not up to date because the date when a medication was discontinued was not entered on to the record. The storage of medication was satisfactory except that the temperature of the areas where medication was kept was not monitored and recorded. One service user was on temazepam but this was not stored in the Controlled Drug cupboard provided. The home did not have a Controlled Drug register. THE RED HOUSE Version 1.10 Page 13 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 standard(s) 12, 13 & 15 Service users maintain family contact and participate in various planned activities in house. The meals in this home are good, offering both choices, variety and catering for special dietary needs. EVIDENCE: The home has appointed a new activity worker. The manager informed the inspector that this appointment was transferred from one of the local authority homes that recently closed down. On the first day of the inspection the inspector observed a number of service users participating in a group activity session in the main reception area. Displayed on the resident’s notice board was the weekly timetable of planned activities for the week. The home has a tuck shop on site and the hairdresser visits once a week. Information with regards to service users contact information was recorded on file. The home has a visitor’s book that is positioned at the front of the home. Service users are offered a choice of three meals at lunchtime, with additional options of boiled/mashed potatoes, rice, pasta and vegetables. A dietician has approved the menus. The registered provider is to be commended for the choice of food available in the home. At present an agency cook is covering the kitchen as the permanent cook has been off sick for a number of months. The food served was nutritious and well balanced and the portions large. THE RED HOUSE Version 1.10 Page 14 Service users said that they enjoyed their meals. THE RED HOUSE Version 1.10 Page 15 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 standard(s) 16 & 18 The home has a satisfactory complaints system with some evidence that service users feel that their views are listened to and acted upon. Service users are protected with the knowledge that staff are well trained and understand the procedures with regards to abuse. EVIDENCE: The home has a complaints procedure, which is included in an information pack, given to service users on admission. This document includes contact details for the Commission for Social Care Inspection (CSCI). The record of complaints showed that no complaints had been recorded. Complaints were discussed with the manager with regards to verbal complaints such as a ‘service user not happy with the food provided or that they are cold’. It was advised that the manager should discuss this with the care team as to how this is monitored and recorded appropriately. A copy of the London Borough of Haringey Adult Protection Procedure was available in the home. Discussion with a member of staff showed a good understanding of why some service users may be verbally or physically aggressive. However, the inspector did not examine the training records it is planned that this will be followed up at the next inspection. THE RED HOUSE Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 23 & 26 The registered person has failed to ensure that service users live in a safe, well maintained, clean, pleasant and hygienic environment. EVIDENCE: The home is split into four units Maple, Cedar, Willow and Beech. Each unit consist of a number of single bedrooms, toilets, a shower room, bathrooms, lounge/dining area and a kitchenette. All service users have their own bedrooms. The bedrooms are reasonably decorated. However, the communal areas are in need of some urgent attention. At the previous inspection it was required that all the bathrooms and toilets are to be upgraded, each kitchenette are be replaced and redecorated and all communal carpets areas replaced. It was evident that this was not been completed. The manager informed the inspector that a part of the local authority’s refurbishment plans for The Red House would start in January 2006. In view of this the CSCI will be requesting an action plan with regards to the proposed plans for the refurbishment to the home, including the general maintenance and upkeep of the building. THE RED HOUSE Version 1.10 Page 17 During the tour of the building it was evident that the home needs some works completed both internally & externally. However, it was stated to the manager that some areas needed to be addressed immediately. These include the following: • To replace the toilet brushes in the each of the toilet areas in the home, as the old ones are unhygienic and old. • To ensure at that there is paper towels and toilet tissues in the dispensers positioned in the toilets at all times. • Cleaning products found in Toilet 40 must be removed and kept in a locked cupboard • Repair the damage to the ceiling in toilet 41 • Fix the broken lock in Toilet 40 • Ensure all bins in the building have a lid • Net curtains in Toilet 42 needs washing or replacing • Shower mat in shower room 43 needs replacing as mouldy. • Shower curtain in shower room 43 needs replacing • Shower chair in shower room 43 is needed. The chair at present is not appropriate for the needs of the service users. It is advised that an Occupational Therapist (OT) be contracted for advice and guidance on what type of chair is appropriate for the service users in the home. • Areas in front of the windows in the dinning/lounge areas must be kept cleaned. • The cupboards for storing care plans were found in all the units to be either broken or not secured. These must be replaced with a secure lockable unit so that such records can be stored appropriately. • Chest of drawers found in the hallway of each unit must be removed and appropriate storage must be found for spare clothes and linen, which is currently stored in them. • Equipment such as wheelchairs, broken walking sticks and other aids found stored in the toilet areas must removed and stored appropriately • Fire door found wedged open – fire doors must be kept shut or alternatively held open with the installation of Dorguard or automatic self-closures mechanism. • All toilets need new toilet seats, as the present ones are worn and unhygienic. • The grass areas around the home needs cutting regularly • Fire guards are needed on all the radiators • The standing bath must be serviced and repaired Service users bedroom windows had been left open by cleaning staff after they had left the room. The registered manager told the inspector that the policy of the home was that windows were to be fully opened to air the room only whilst staff were in the room to clean it, and restrictors must be in use when they leave the room. The registered manager spoke to the staff involved. The registered manager must ensure that window restrictors are in operation at all times when the room is not being cleaned. While there was a domestic cleaner employed on a daily basis the home was found to have an offensive odour, THE RED HOUSE Version 1.10 Page 18 dirty and un-kept. This was observation was relayed to the manager who was accepting of the comments made. The home does have in place an infection control policy. The laundry room is on the ground floor and the home employs a laundry assistant daily. The home has industrial washing machines and dryers in place. It was evident at the back of the washing machine that the liquid detergent soap and conditioner was dispensed automatically into the machine. However, the containers used were the incorrect bottles for the washing machine and also the tubes were leaking and the area to the back of the machine was a mess. The laundry assistant explained that the home has always purchased smaller bottles of liquid detergent and conditioners. It was advised that the manager ensure that the correct liquid detergent bottles are purchased for use with the washing machine. THE RED HOUSE Version 1.10 Page 19 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 28 The home has ensured that the skills mix of staff meets service users needs. However, this is not consistent on a daily basis. EVIDENCE: The current staffing arrangements in place are as follows:Cedar: there is one permanent care staff and one floater and at night one night care staff supporting eight service users. Beech: there are two permanent care staff Maple: there is one permanent care staff and one floater shared between Maple unit and Cedar unit and two night care staff. Willow: there are two permanent care staff and one night care staff. Staffing levels was discussed with the manager who stated that the local authority is negotiating the staffing levels in the home. It was advised that any proposed changes to the staffing levels must be discussed and agreed with the Commission. The manager stated that a number of vacancies were filled by care staff from one of the local authority’s care homes that recently closed down. The present vacancy in the home is reported to be 10 hrs. The home has employed a handyperson but the manager is waiting on recruitment clearance first. The manager informed the inspector that a number of care staff are at present undertaking their NVQ level 2 and above in care. On day one of the inspection one of the NVQ assessor arrived to see one of the care staff. The assessor THE RED HOUSE Version 1.10 Page 20 stated that the care staff has completed a number of their units and they will complete their NVQ shortly. Personnel records were not examined at this inspection. This is planned to be completed at the following inspection. THE RED HOUSE Version 1.10 Page 21 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 & 38 The home now benefits from a leader, however, there are a number of areas that the manager needs to address to ensure the care needs for service users are fully met. Service users are assured that their health and safety is promoted and protected, however, this is not always consistent. EVIDENCE: The manager has recently return back to work after a period of being absent from the home. The care staff spoken to stated that they were happy to see the manager return back to work. The inspector observed the way service users and the care staff greeted the manager during the tour of the building. At the previous inspection it was required that the registered manager ensures that the time taken to evacuate the building is recorded in the fire drill records. Upon reading the fire drill records it was evident that the time taken to evacuate the building was recorded, however, the last recorded fire drill was completed in December 2004. It is reminded that records of fire drills be completed at least once every three months. THE RED HOUSE Version 1.10 Page 22 A number of fire doors were found to be wedged open. The inspectors were able to walk into different units within the home un-challenged by care staff on duty. A number of care staff on the units were asked about the security protocol within the home and who was the responsible person within the unit. It was unclear from the response given that care staff fully understood the home’s security protocol. The inspectors pulled the emergency alarm button in one of the bathrooms on the third day of the inspection. It took the care staff on that particular unit some time to investigate the situation. The care staff stated that they were the only person on duty at the time and they were in the middle of supporting a service user. Both these areas were addressed with the manager at the end of the inspection during the feedback session. It was advised that this is to be addressed with the care staff during team meetings. THE RED HOUSE Version 1.10 Page 23 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 1 x x x 2 2 x 1 STAFFING Standard No Score 27 2 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x 3 x x x x x 2 THE RED HOUSE Version 1.10 Page 24 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 3 Regulation 14(1)(a) Requirement The registered person must ensure that no service user moves into the home without having their needs assessed and been assured that these will be met by the home. The registered person must submit details regarding a detailed account of all the service users in the home. This is to include the units the service users reside in, client catergory and details of each service users level of need (i.e. what level of assistance is required in relation to personal care The information is required in order that an assessment may be made as to the adequacy of current staffing levels. The registered person must ensure that all fire doors are able to effectively self-close at all times and are not wedged open. The registered person must ensure that a risk assessment is in place for a specific service user who likes their bedroom door wedged opened. This is to include what action the home has put in place to assist the Version 1.10 Timescale for action 30 July 2005 And from then on 15th June 2005 2. 3 14(1) 3. 4 13(4)(a) (b) 16 July 2005 And from then on THE RED HOUSE Page 25 4. 23 23(1) 4(3) 5. 7 17(1)(b) 6. 19 23(2)(b) 7. 16 22 8. 7 12(1) service user. The registered person is to consider whether or not to put in place magnetic door closures on the specific service users bedroom door. The registered person must ensure that window restrictors are in operation at all times when the room is not being cleaned. (Previous timescale 6 September 2004 not met) The registered person must ensure that care plans for individual service users are kept securely in the care home. The registered person must therefore obtain a secure lockable cupboard for each unit of care plans. The registered person must submitted to the CSCI a comprehensive action plan which clearly states the timescale of when works are to be completed on the Bathrooms and toilets, the kitchenettes in each unit and the replacement of carpets in all the commual area. (Previous timescales 1st April 2005 not met). The registered person must find appropriate ways of ensuring that all complaints by service users, especially verbal communication are recorded and acted on by the manager. The registered person must ensure that all service users healthcare, social, and emotional needs are addressed, recorded and monitoried monthly by the home. Risk assessments are to be updated accordingly when any changes occur. This is to be detailed with outcomes and support needed, then signed and dated when completed. Version 1.10 16 July 2005 And from then on 16 July 2005 And from then on 30 July 2005 16 July 2005 And from then on 30 July 2005 And from then on THE RED HOUSE Page 26 9. 7 12(5)(b) 10. 9 13(2) 11. 9 13(2) 12. 9 13(2) 13. 9 13(2) 14. 9 13(2) The registered person must ensure that the care staff are respectful to service user wishes with regards to their preferred choice and needs on a daliy basis. The registered person must ensure that all prescribed Chloranphenicol eye ointment is kept in the fridge at all times until used and after 28 days as stated on the bottle this is to be discarded. The registered person must ensure that all as when required medication (PRN) has guidelines in place with regards to when the medicaiton can be adminstered to the individual service users. The registered person must ensure that care staff wash their hands before adminstering medication to service users. The registered person must update the medicines policy to include sections dealing with: · the receipt of medication · the possibility of disguising the medication, if non administration will seriously endanger a service user’s health. · the possibility of service users wishing to administer their own medication. · retaining of medication for a period of seven days in the event of the death of a service user in case there was a coroners inquest The registered person must ensure that suitable times are found to administer medication to all service users. Necessary medication must not be omitted just because a service user is still asleep at the time of the morning medicine round. Version 1.10 16 July 2005 30 July 2005 30 july 2005 16 July 2005 And friom then on 16 August 2005 30 July 2005 THE RED HOUSE Page 27 The registered person must ensure that all the service users’ medication histories are kept up to date. The registered person must ensure that temazepam is kept in the Controlled Drug cabinet provided. The receipt, administration and disposal of Controlled Drugs should be recorded in a Controlled Drug register. 15. 9 13(2) The registered person must ensure that the temperature of the areas where medication is stored is monitored, recorded and maintained at 25oC or below. The registered person must ensure all seventeen points under the section on Enivironment is addressed within the timescale specified. The registered person must ensure that all radiators have fireguards in place and the standing bath is serviced and repaired. The registered person must ensure that the home is kept clean and free from offensive odours. The registered person must cease the practice of using the inappropriate liquid detergent and conditioner containers. This is deemed a health and safety hazard. The registered person must therefore purchase the correct liquid detergent and conditioner containers for the washing machine and these are to be installed appropriately and safely. The registered person must repair the washing machine that has a faulty lead for the liquid Version 1.10 30 July 2005 16. 24 23(2)(b) 30 July 2005 17. 19 13(4)(a) (b) & 23(2)(c) 23(2)(d) 16 August 2005 18. 26 30 August 2005 30 July 2005 And from then on 19. 26 13(4) & 23(2)(d) THE RED HOUSE Page 28 detergent dispenser. 20. 38 23(4)(e) The registered person must ensure that fire drills are completed at least four times a year and a record of this is kept on file. The registered person must ensure that all care staff are aware of the security protcol based on service users vulnerability in the home and this is monitored and reviewed accordingly. The registered person must ensure there are systems in place to ensure that there is a quick response whenever the alarm system is activated ensuring the welfare of the service user concerned is addressed. 30 July 2005 21. 38 13(4)(a) (c) 30 July 2005 And from then on 22. 38 16(2)(c) 30 July 2005 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 3 Good Practice Recommendations The registered person should amend the admission assessment to included a section on service users likes and dislikes and any special requirements with regards to their day and night time routine. It is recommended that the registered person should stagger the times medication is adminstered to service users on a daily basis to ensure medication is offered at a time that suit service users needs in the home. It is recommended that records of fire drills include the date, time, the length of time it takes for all persons involved in the drill to assemble at the meeting point and a list of all persons involved. 2. 9 3. 38 4. THE RED HOUSE Version 1.10 Page 29 Commission for Social Care Inspection Solar House, 1st Floor, 282 Chase Road, Southgate, London, N14 6HA 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 THE RED HOUSE Version 1.10 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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