Inspection on 26/02/07 for Red Houses (The)

This inspection was carried out on 26th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 Houses (The) 29/01/09

Red Houses (The) 11/10/05

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 Lisa Johnson Unannounced Inspection 26th February 2007 09:00 Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 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.V327680.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 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.V327680.R01.S.doc Version 5.2 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.V327680.R01.S.doc Version 5.2 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 11th October 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 decorated in a homely style and all service users have individual bedrooms ad ate provided with specialist equipment. 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. The weekly charges are £1,553 Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit was part of a key inspection. The visit was unannounced and took place over six hours commencing at nine am and finishing at three pm. Mrs. L Johnson regulation Inspector carried out the visit. Mr. C Mozo registered manager represented the establishment. Due to communication difficulties experienced by the service users their direct views about their care could not be obtained. Therefore observations of interactions and service user responses through non- verbal communication have been reflected in this report. A full tour of the premises took place. Information was examined which was provided by the manager with the pre inspection questionnaire. Staff training records, and policies and procedures were sampled. The inspector spoke to three members of staff. Feedback questionnaires were provided to the home to give to service users relatives and representatives to gain their views on the care provided but none have been returned to the Commission. The inspector would like to thank the staff and service users for their time, assistance and hospitality during this inspection. What the service does well: The service provides a warm, friendly and homely environment. The home provides a good standard of accommodation, which has been adapted to meet the needs of service users. The home provides a wide range of sensory equipment for the enjoyment of individuals living in the home. There is a well-established staff team who have supported service users for a number of years and who have a good knowledge of their needs. Good relationships were observed between service users and staff who were able to respond to the communication methods of the service users. There was a happy atmosphere in the home and service users were observed to be relaxed in the company of staff. One individual who has limited verbal communication knew the names of staff and good interaction was taking place. Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 Page 6 The home has introduced Health Action Plans, which were individualised and detailed. The home has produced communication passports, which includes the likes, dislikes and preferences of service users. What has improved since the last inspection? 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 Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 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.V327680.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. The needs of service users are assessed prior to admission to the home. EVIDENCE: The current service users have lived in the home for a number of years and there have been no new admissions. However a detailed admission procedure was in place called a “Moving in policy” which stated that that a care assessment would be obtained from the local authority. A full assessment would be carried out by a competent person and areas to be assessed would include personal support, education, family, social contacts, management of risks, cultural and faith needs, physical health, gender needs, specialist input, treatment and communication. Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with an individual care plan, which records their individual needs and goals. Service users are supported to make decisions about their lives with assistance and are supported to take risks as part of an independent lifestyle. EVIDENCE: Three care plans were sampled during this visit. Each service user has a completed care plan, which includes personal care, communication, health, emotional, recreational, social and cultural needs. It was clear that plans were regularly reviewed and were signed by the author. Care plans sampled could not be signed by service users to agree to their plan as a result of their needs and disability and this was recorded in their plan. Three members of staff spoken with during this visit and who act as key workers confirmed that they were aware of service users individual plans and are involved in completing Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 Page 10 monthly reviews. The manager stated that the company would be introducing person centred planning in the near future. Due to the limited communication abilities of the service users information and decision-making has been acquired from a range of sources including families and from staff who have been working with the service users for a number of years. Each individual has a communication passport which details information about each individual and assists staff with their understanding such as their “likes and dislikes”. One individuals plan identifies he likes “beer” to drink and staff spoken with stated that service users have the opportunity to visit pubs and restaurants. Staff spoken to during this visit had a good knowledge of service users needs and were observed to be responsive to their expressions and other non verbal methods of communication. Evidence was observed that manual handling risk assessments and tissue viability assessments had been completed. Other risk assessments and guidelines sampled included plans for service users identified at risk of choking and who may have emotional difficulties. Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with a range of appropriate activities and engage in a range of leisure activities. Service uses are supported to take part in the local community and the rights and responsibilities of service users are respected. The home is able to demonstrate that service users are provided with a wellbalanced and nutritious diet EVIDENCE: The home provides a range of activities for service users to participate in with each individual having their own activities plan in place. During the visit one person left the home to attend day services and some other individuals went out to the shops with staff. One person was observed to be spending time in the kitchen while the member of staff was cooking the lunchtime meal. Other activities include reflexology, aromatherapy, theatre trips, sensory activities, visiting restaurants and trips out. Daily care note were sampled provided evidence that activities were taking place. Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 Page 12 Some individuals maintain links with their families and visit their relatives or receive visits in the home. The manager stated that contact has been made to advocacy services and this service is able to provide support on behalf of service users if any issues arise, but they are not presently able to provide permanent support to individuals. During this visit positive interaction was observed between service users. Staff were observed to treat service users with respect and sensitivity. Copies of the homes menus were provided with the pre- inspection information and at lunchtime a hot meal was served and it was reported by staff that the main meal is served in the evening. The menus were varied and well balanced. Each individual’s likes and dislikes were recorded and instructions relating to how their meals and refreshments need to be served. Some individuals require their drinks to be thickened or cut up due to the risk of choking. During the meal staff were observed to provide appropriate assistance and were talking and interacting with service users ensuring that service users mealtimes were an enjoyable experience. Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is able to demonstrate that service users receive personal support in the way they prefer. Service users physical and health needs are met and they are protected by the homes medication administration procedures. EVIDENCE: The home has introduced health action plans, which were individualised with photographs. Plans were detailed and well presented and consisted of “An about me section” and provided information about all aspects of each individuals health, medication and health screen checks. Plans sampled provided evidence that individuals with visual difficulties are supported to receive regular eye examinations. It was clear that service users are supported to access a range of health care professionals such as a General Practitioner, dentist, occupational therapist, physiotherapist, dietician and chiropody. One person was observed being supported to attend an appointment with a health care professional. A wide range of specialist equipment was available in the home to meet the needs of service users. Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 Page 14 Service users privacy was respected when receiving personal care with bedroom and bathroom doors observed to be kept shut. Positive relationships were seen between service users and staff and it was observed that service users were relaxed in the presence of staff. Staff had a good knowledge and understanding of individuals needs and were able to respond to their non-verbal forms of communication. The homes medication administration systems were examined and records were adequately maintained. A list was maintained of staff authorised to administer medication and photographs of individuals were available with their medication card. Protocols were in place for the administration of “as required medication”. Medication is dispensed from Lloyd’s pharmacy who provides training for staff. Disposal records were available. The home has a medication policy in place and the Royal Society Pharmaceutical guidelines were in place for staff reference. Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is able to demonstrate that the views of service users are listened to and acted upon. Service users are protected from abuse. EVIDENCE: The company has produced a complaints procedure, which is formulated in large print and pictures. Due to the needs of the service users they would not be able to make a complaint and that if this was required a representative would need to raise any issues on their behalf. The manager stated that no complaints have been received since the previous visit and complaint records were maintained. During this visit he home provided a happy and caring atmosphere with good interaction being observed between staff and service users. Staff training records sampled indicate that staff have received training in safeguarding adults from abuse and the manager has attended the local authority safeguarding adult training. The home has a copy of updated the local authority multi agency safeguarding adult’s procedure and a whistle blowing policy is in place. Two members spoken with were clear in their responses as to their responsibilities if they ever witnessed any abuse. Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,29 & 30 Quality in this outcome is excellent. This judgement has been made using available evidence including a visit to this service using available evidence including a visit to this service. Service users live in a safe, well-maintained, comfortable and clean environment. Service users are provided with the specialist equipment they require maximising their independence. EVIDENCE: The home provides a high standard of accommodation and has been designed and adapted to meet the needs of service users. The home is spacious and well furnished. Since the previous visit a number of areas have been redecorated. Bedrooms were painted in different colours that were bright and cheerful and which also reflected the gender of service users and were individually personalised. There is a well-maintained garden, which is accessible and includes a patio area and pergola. Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 Page 17 There is a large sitting room, which contained multi sensory equipment, and tracking has been installed. Appropriate equipment has been provided in bedrooms and assisted bathrooms, which meets the needs of service users. The home has a separate dining room and conservatory, which is provided with blinds. The inspector was informed that the home is waiting for a new kitchen to be installed and some of the drawers and cupboards were observed to be worn. There is a separate dining room, which is only use on occasions, and service users take their meals in the kitchen. It was recommended that the company consider extending this are there was limited space when everybody was utilizing it. The home was cleaned to a high standard and was hygienic. Separate laundry facilities were in place and appropriate hand washing materials were present in toilets and bathrooms and the infection control procedures were in place. Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Competent, qualified and appropriately supervised staff supports service users. Service users are protected by the homes recruitment policy and practices. EVIDENCE: During this visit there was four members of staff on duty. The duty rotas indicated that three staff work on the afternoon shift. At nighttime there is one waking member of staff and a sleep in member of staff provides support and rotates between other services near by. There is always an on call manager after hours who is available to be contacted to provide support where this may be required. There is a consistent staff group who have been employed in the home for a number of years who have a good knowledge of the needs of service users. Staff spoken to during this visit had a clear understanding of their roles and responsibilities. During this visit training records were sampled for three members of staff. Each staff member has their own training record in place and it was evident that staff have received up to date mandatory training in safeguarding adults, fire awareness, food handling, first aid and moving and handling. The home is Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 Page 19 able to demonstrate that staff receive training and development, which supports the needs of service users including for example epilepsy with other training being arranged for person centred planning, risk management, equality and diversity. The manager stated that he has completed training in health action plans. Pre- inspection information provided by the manager stated that staff have a “learning opportunities guide” to access any additional courses and that forty four percent of staff hold National Vocational Qualifications (Level 2) or above. Staff receive regular formal supervision, which was evident by schedules maintained and confirmed by staff spoken with during this visit. Three staff personnel files were sampled and contained the required documents and evidence of Criminal Record Bureau checks. These files contained a lot of information due to these individuals being employed by the organisation for a number of years. The manager was advised that he should consider reorganising these files to make the information more accessible. Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is able to demonstrate that service users benefit from a well run home. The health safety and welfare of service users is protected and the home is run in their best interests. EVIDENCE: The registered manager is a qualified mental health nurse and holds the Registered Managers Award and has been in post for a number of years. There was an open atmosphere in the home and members of staff spoken with stated that they felt well supported by the manager and that he is approachable. Staff spoken with also stated that regular meetings are held and that there is good team work. Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 Page 21 Evidence obtained during this visit indicated that that surveys had been sent out to relatives over a year ago and the manager stated that a new format is being introduced which was shown to the inspector. The home is advised to analyze the outcomes of the questionnaires and provide feed back to service users and their representatives to ensure that that the home is run in the best interest of service users. The responsible individual conducts monthly quality visits with the reports being maintained in the home, which were available for viewing. Preinspection information provided evidence that the home has a range of policies and procedures which are accessible to staff and some procedures sampled during this visit had been printed in service user-friendly formats. The home has now introduced a visitor’s book to record the names of all visitors to the home Substances hazardous to health were stored securely and appropriately. Health and safety checks are regularly completed and recorded. Fire records were appropriately maintained and water temperature records were regularly recorded. Examination of records and certificates identified systems are in place for routine service and maintenance arrangements for the environment. Red Houses (The) DS0000013755.V327680.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 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 X 27 X 28 X 29 4 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 3 X 2 X X 3 X Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA28 Good Practice Recommendations It is recommended that the company completes the refurbishment of the kitchen and considers extending the size of the kitchen. The registered person should consider reorganising the staff personnel files to improve accessibility. It is recommended that the outcomes of the quality assurance questionnaires are analyzed and fedback to service users and their representatives. 2 3 YA34 YA39 Red Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 Houses (The) DS0000013755.V327680.R01.S.doc Version 5.2 Page 25 - 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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