Inspection on 11/10/05 for Red Houses (The)

This inspection was carried out on 11th October 2005.

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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Red Houses (The) 29/01/09

Red Houses (The) 26/02/07

Red Houses (The) 16/11/04

Red Houses (The) 13/07/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Sutton Lodge Nursing Home

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 Red Houses (The) The Red Houses 563-565 Stroude Road Virginia Water Surrey KT16 0PT Lead Inspector Sandra Holland Announced Inspection 11th October 2005 10:30 Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 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 Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Red Houses (The) Address The Red Houses 563-565 Stroude Road Virginia Water Surrey KT16 0PT 01344 845240 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) Welmede Housing Association Ltd Mr Carlos Mozo Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Of the 6 residents accommodated, up to 6 may fall within the category PD, in addition to the category LD The age range of those accommodated will be 25-60 Years. Date of last inspection 10th May 2005 Brief Description of the Service: Red Houses is a large, purpose built, detached bungalow situated in the village of Virginia Water. It is owned and managed by Welmede Housing Association and the staff are employed by the North Surrrey Primary Care Trust (NSPCT). The service provides accommodation for up to six younger adults who have complex physical or learning disabilities. The home is attractively decorated in a homely style and all service users have individual bedrooms. A large lounge, separate dining room and conservatory provide a generous amount of communal space. There is a large enclosed garden with lawn and patio areas to the rear of the property and off street parking is available to the front. Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was the second to be undertaken in the Commission for Social Care Inspection (CSCI) year April 2005 to March 2006. Mrs. S. Holland, Lead Inspector for the service, carried out the inspection. Mr. Carlos Mozo, Registered Manager was present, representing the service. A tour of the premises took place and a number of records and documents were examined, including supervision records, residents’ finance records and health and safety records. The inspector met five of the six residents and spoke to five members of the home’s staff and a visiting “floating” member of staff. As the group of people living at the home are more generally known as residents rather than service users, the term residents will be used throughout the report. Due to the varying degrees of difficulty with communication experienced by the residents, the information for this report was obtained by limited communication with some residents, speaking to the staff and looking at records. For other residents, information was gained by observing their facial expressions and body language. Further information was supplied by the home in the completed and returned, pre-inspection questionnaire. The inspector would like to thank the residents and the staff for their hospitality, time and assistance. What the service does well: What has improved since the last inspection? The nighttime needs of residents are being reviewed to ensure that enough staff are available to safely meet their needs. Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 6 Photographs of staff have now been obtained. Guidelines have been drawn up, to advise staff in when to administer medication prescribed, “as required”. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. The home aims to meet residents’ needs and aspirations. EVIDENCE: The manager stated that due to the limited communication abilities of the residents, the knowledge of their needs and aspirations has been obtained from a variety of sources. These have included resident’s families or representatives, other healthcare professionals involved in their support and from staff who have been involved in supporting the residents for many years. Each resident in the home has a communication passport, which lists information about them, including their likes and dislikes for example. These have been developed and drawn up with the involvement of a speech and language therapist. This assists staff, and new staff in particular, to know and understand each resident. The manager advised that residents’ needs and aspirations would be assessed prior to admission to the home and that all supporters of the resident would aim to meet these. Prospective residents would be offered short visits or trial stays in the home to enable staff to get to know the resident and understand their needs. Any specialist support needed by residents, would be sought as soon as the need was identified, staff advised. Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 9 Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 10. Decisions have to be taken on behalf of residents. EVIDENCE: The manager explained that due to the complex disabilities of the residents, it is not possible for them to make their own decisions. Decisions therefore have to be made on residents’ behalf by their families or representatives, by advocates acting on their behalf, by their key workers or by staff. Decisions made on behalf of residents are based on the knowledge held of their preferences, of their past history and using records held. Staff advised that they are aware of the issue of confidentiality, of the home’s policy and of the need to protect against the release of information, inappropriately. They do not provide enquirers with information about residents without reference to the manager, or ensuring that the enquirer is entitled to the information requested. Staff stated that they take care not to speak about residents in front of other residents. Records held in the home were stored securely and appropriately. Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 11 Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11 and 17. Personal development opportunities are limited. Meals are appetising and well balanced. EVIDENCE: Although residents are encouraged to maintain the skills they have, the manager stated that due to the limited abilities of the residents, it was unlikely that they would develop further. The manager advised that as the residents are getting older, some of their abilities such as mobility are naturally deteriorating. Staff said they are aware of maintaining residents’ independence wherever possible. Staff advised that the main meal of the day in the home is served in the evening, with a light lunch served midday. A continental style breakfast is served during the week, and a cooked breakfast brunch is served at weekends. All residents require assistance with meals and require food that is cut into small pieces or of soft consistency due to the risks of choking. Some residents have their drinks thickened, with a prescribed product for the same reason. Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 13 The home has a cheerful and bright kitchen, fitted and equipped in a family style, and some residents have their meals here. Two residents were enjoying their lunch in the kitchen on the day of inspection, being sensitively supported by two members of staff. Three other residents had gone out to lunch at a local restaurant and for a drive, with members of staff and a “floating” support worker, and one resident was attending a day centre. Staff advised that an informal menu plan is arranged, to incorporate the known preferences of the residents and to ensure that each person has their individual preference included. Fresh vegetables are regularly used and fresh fruit is freely available, which staff prepare and serve appropriately for the residents’ needs. Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this inspection. EVIDENCE: Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. The home has a complaints policy and procedure but any complaint would have to be made on behalf of a resident. EVIDENCE: The manager stated that the residents are not able to make a formal complaint, and that if this were required, a family member, representative, advocate or member of staff would need to act on behalf of the resident. Staff stated that they are sensitive to individual resident’s needs, moods and responses and these are used to assess if a resident is happy or unhappy in any way. Staff advised that they would take action on behalf of residents if needed. Details of how to contact an advocacy service are obtained as required at present, the manager advised. It is recommended that these be obtained and displayed in the home, for use by anyone requiring them. The manager stated that he is the appointed person in the handling of some aspects of the residents’ financial affairs. To protect residents from financial abuse, two staff sign for each transaction and detailed records are maintained of these. Withdrawals from accounts are listed in a ledger, which is also used to record purchases made and the details of the appropriate receipt. The records were seen to be correct, with the amounts held, accurately matching the record held. The manager stated that Welmede also carry out regular audits, to ensure that residents’ monies are handled appropriately and entries were seen in the ledgers, confirming this. A recommendation has been made. Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28. The home is warm, bright and welcoming. EVIDENCE: Although the home was generally well presented, the manager stated that it is due to be decorated within the next few months, as part of a rolling cycle of maintenance. The majority of areas were colourful, clean and well maintained, providing a comfortable and homely environment. The residents have a variety of shared spaces to use, including the main lounge, a conservatory and a large dining room. The lounge has a Snoozelem, multi-sensory, stimulation system fitted, which provides music, a selection of different lighting effects and vibration mats. It was noted that an area of the wallpaper in the lounge is lifting, but this will be replaced during the forthcoming decoration. Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32 and 36. Staff are aware of their roles and responsibilities. A competent team of staff supports residents. EVIDENCE: Staff stated that they share all roles within the home, including assisting with personal care, activities, shopping, cooking, laundry and domestic tasks. A member of each shift team is allocated as the shift leader and will in turn, allocate other staff to the roles required. Staff advised that the team works well together and is mutually supportive. As mentioned earlier, a number of the staff team have been employed to support the residents for many years, creating a stable and effective team. Information gathered from the pre-inspection questionnaire showed that only a very small number of bank or agency staff are used in the home, to supplement the staff team. This ensures continuity of support and stability for the residents. The manager stated that Welmede, the organisation that runs the home, has been working with him to assess the staffing needs of the home at night time, to ensure the residents’ needs are met. This work is ongoing and details of the options available have been forwarded to CSCI. As part of this assessment, Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 18 the manager stated that a privately funded occupational therapist (OT) assessment is being arranged, due to the very long delays when a National Health Service (NHS) OT is requested. The need for a review was identified by the back care co-ordinator, who highlighted health and safety issues. A number of staff are currently undertaking National Vocational Qualification (NVQ) training in care, some at Level 2 and some at Level 3. The manager stated that he has completed the NVQ Level 4, Registered Manager’s Award. Staff advised that some of their colleagues are not keen to undertake NVQ training for various reasons. This was discussed, the benefits, both to the home and the staff, were pointed out and staff who have achieved the qualification were urged to encourage their colleagues. The manager was advised to ask the NVQ assessor to visit the home and offer reluctant members of staff alternative methods of achieving the qualification. The National Minimum Standards (NMS) specify that at least 50 of the care staff in each care home should be trained to NVQ level2 in care. The manager stated that he carries out supervision and appraisal of staff. Records were seen and showed that supervision is being carried out but not to the required frequency. It is required that supervision is carried out at least six times each year, to enable staff to meet on to one with their line manager and to address any issues raised by either person. A requirement has been made. Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 41, 42 and 43. The quality of the service provided is not reviewed. Health and safety of residents is protected and promoted. EVIDENCE: It was stated by the manager that the home does not have a policy requiring regular reviews of the quality of the service provided, although this is required by The Care Homes Regulations 2001 (As Amended). The manager advised that the residents are not able to give their own views, due to their communication limitations. A selection of feedback comment cards were supplied to the home with the pre-inspection questionnaire. These were to be circulated to any of those involved in the support of residents, such as families and representatives, community nurses, day centre staff and general practitioners. These are designed to obtain independent feedback on the quality of the service provided by the home, but none have been returned to CSCI. Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 20 It was noted that the inspector was not asked to sign in on arrival at the home. This was discussed with the manager, who stated that as the home received few visitors, the visitor’s book had not been maintained. It is a requirement that a record is kept of all visitors to the home. This is to ensure the safety of the residents and that of the visitors, in the event of an emergency such as a fire. A number of records relating to health and safety were examined, including fire safety records, the accident record book, gas and electrical safety records and records relating to water safety. All were maintained to the required frequencies and within appropriate ranges. Details of the financial position of the home are provided on an annual basis to the manager, he stated. This lists the income from fees and the outgoings, which are itemised to show all costs, including for example, staff costs, utilities, maintenance, food, travel and communication. This plan indicates that the home’s annual income should cover its costs. A monthly report of the amounts spent by the home is also provided, to enable the manager to monitor the budget. This was seen to be within the budgeted amount. Requirements have been made. Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 3 x x Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x 3 x x 3 Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x 2 x x LIFESTYLES Standard No Score 11 3 12 x 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score 3 2 x x x 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Red Houses (The) Score x x x x Standard No 37 38 39 40 41 42 43 Score x x 2 x 2 3 3 DS0000013755.V253966.R01.S.doc Version 5.0 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA36 Regulation 18 (2) (a) Requirement The registered person must ensure that persons working at the care home are appropriately supervised. The registered person must establish and maintain a system for reviewing at appropriate intervals and improving, the quality of care provide at the care home. A report in respect of any review conducted must be made supplied to CSCI and available to residents. The system must provide for consultation with residents or their representatives. The registered person must maintain in the care home the records specified in Schedule 4 of The Care Homes Regulations 2001 (As Amended). Specifically, a record of visitors to the home must be maintained, including the names of visitors. Timescale for action 08/11/05 2 YA39 24 (1-3) 13/01/06 3 YA41 17 (2) 08/11/05 Red Houses (The) DS0000013755.V253966.R01.S.doc Version 5.0 Page 23 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 3 Refer to Standard YA22 YA28 YA32 Good Practice Recommendations It is good practice to display contact details of local advocacy services in the home, to be available for all who may wish to use them. It is recommended that the wallpaper in the lounge is replaced when the home is decorated. It is good practice that care staff are trained to at least NVQ Level 2 in care. 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