Inspection on 26/06/07 for Red Lodge

This inspection was carried out on 26th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Lodge 30/09/08

Red Lodge 03/03/06

Red Lodge 05/10/05

Red Lodge 13/01/05

Red Lodge 06/09/04

Red Lodge 24/02/04

Red Lodge 15/12/03

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Red Lodge Hawthorn Terrace New Earswick York YO32 4ZA Lead Inspector Kate Shackleton Key Unannounced Inspection 09:30 26th June 2007 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000015838.V335096.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000015838.V335096.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Red Lodge Address Hawthorn Terrace New Earswick York YO32 4ZA 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) 01904 762111 Joseph Rowntree Housing Trust Mrs Susan Veitch Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places DS0000015838.V335096.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd March 2006 Brief Description of the Service: Red Lodge is part of the Joseph Rowntree Housing Trust and is situated in the village of New Earswick on the outskirts of York. The home is close to the local shops, post office and has good public transport links into York. Red Lodge is a large building that can accommodate up to 42 service users who require personal and social care. The premises include 36-sheltered housing flats, where tenants can receive a domiciliary care service from staff based at Red Lodge. Information about the service is provided in the homes brochure given to residents and or their representatives and a copy of the Commission for Social Care Inspection report can be obtained from the manager. At the time of this visit fees ranged from £349:94 to £400 per week. DS0000015838.V335096.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The accumulated evidence used in this report has included: • A review of the information held on the homes file. • Information submitted by the registered manager in the Pre Inspection Questionnaire • An unannounced visit to the home. The visit included talking to the residents, management and staff. A tour of the premises and a sample of records were examined. • Three residents were selected to case track. This involved looking in detail at their records to assess if they were receiving the care that they needed. Each resident was spoken to in private to hear their views about the care that they received. Other residents were also spoken to during the visit. • Surveys received from seven service users. What the service does well: The service has a clear referral and assessment process. People who use the service or their representatives are given enough information about the home so that they know what to expect. A manager visits the prospective resident to find out what support they need and the best way for the service to provide the help needed. The person and or their representative are always offered the opportunity to visit the home before making any decision. This allows the management the opportunity to decide whether they have the staff and resources to meet the persons’ needs before offering accommodation in the home. It also allows time for everyone to have their questions answered and decide if they want to go ahead and make arrangements for admission. Residents live in a clean fresh comfortable home. The staff team provide support in a kind and helpful manner. All residents have a detailed plan of care, which makes sure that all of their needs are identified and provides staff with information about how the resident wants the care delivered. Residents are actively encouraged to be involved in the running of the home. This promotes their right to have a say in the care delivered and stay in control. It also makes sure that all of their needs are considered. There are clear ways in which quality can be measured which include feedback from DS0000015838.V335096.R01.S.doc Version 5.2 Page 6 people who use the service. This ensures that the service continues to deliver care in their best interests. The safety and protection of people who use the service and staff is an important aspect of the service delivered. It is demonstrated through robust policies and procedures, proper risk assessments, staff training and the servicing of equipment. The staff are provided with comprehensive training to improve their knowledge and skills. This means that care is delivered from a well-informed staff team whose practice is up to date. Comments like “The staff would do anything for you” and “The food is good and the staff are very nice” were heard. Care workers are well supported by management, which enables them to do their job well. The home is managed in a manner that concentrates on the needs, wishes and views of the people who use the service. 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. DS0000015838.V335096.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000015838.V335096.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 does not apply to this service. People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Proper assessments are done prior to admission. This seeks to ensure that the service can meet all of the prospective residents care needs. EVIDENCE: Files examined confirmed that comprehensive assessments are completed prior to admission. The manager will do the assessment wherever the prospective resident or their family chooses. This can be either at the persons own home, in hospital or at Red Lodge. Relatives are involved where possible to find out more information than the prospective resident may be able to provide. At this visit the manager explains how she feels the service can meet the needs of the person needing care and assesses if any specialist equipment needs to be provided in the home. DS0000015838.V335096.R01.S.doc Version 5.2 Page 9 Everyone is offered the opportunity to visit Red Lodge prior to moving in and to stay for a meal if they want. It is sometimes the case that relatives/representatives visit and make the decision on behalf of the person requiring care. On the day of admission an individual member of staff is allocated to help the person settle in. Everyone is admitted for a trial period to make sure that they settle and want to stay followed by a six-week review of the situation. Discussions with resident’s and feedback from surveys confirms that the admission process is done in a manner that ensures prospective residents/relatives have the information they need to make an informed decision about whether or not to live at Red Lodge. DS0000015838.V335096.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 and 10. People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s personal, social and health care needs are met. EVIDENCE: The home has a strong ethos for involving residents in all aspects of their lives. Files examined confirmed that care plans are comprehensive. Staff work with residents to develop their plan. The plan is a working document. It contains sufficient detail to ensure that care staff knows the support they have to provide to meet the diverse needs of residents in a manner that promotes independence and respects privacy and dignity. Each plan contains comprehensive risk assessments. Management of risks takes into account the needs of service users balanced with their aspirations for independence and choice. The plan is periodically reviewed and updated as DS0000015838.V335096.R01.S.doc Version 5.2 Page 11 changing needs dictate. Discussed with the manager that best practice promotes a monthly review of the plan. On admission a key-worker is allocated to each resident. The key worker role is to take a special interest in the resident and help them feel comfortable in the home. Residents spoken to said that they received a very good service and are treated with respect. Comments like “On the whole very good”, “The staff would do anything for you” and “The staff are very nice” were heard. People who returned surveys felt that they generally got the care and support they needed. They all felt listened to by the care staff and said that the staff acted on whatever they had to say. Staff were observed providing support in a kind and helpful manner. Staff promotes the rights of residents to access the health care professionals that they need. All residents are registered with a General Practitioner and community nurses visit as and when needed. The home arranges training on health care matters that relate to the health care needs of residents. Residents spoken to say they can see the doctor when they need to. Resident’s surveys confirmed that they receive the medical support that they need. There are medication procedures to guide staffs practice and training is provided on the safe storage, administration and disposal of medicines. Medication is stored and administered in a safe manner. Residents assessed as being able are encouraged and facilitated to keep and take their own medication. DS0000015838.V335096.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are supported to make choices and remain in control of their lifestyle EVIDENCE: Residents spoken to say that they felt in control of their daily lives. They are able to make decisions for themselves as to how they spend their time and said that the routines of the home are very flexible. Routines can be changed to meet individuals changing needs and wishes. Examples given included rising and retiring times, what, when and where to eat and types of activities to be involved in. Staff training and the homes policies and procedures focus on residents being in control of their lives. Residents care plans detail the types of activities that they enjoy. The views of residents are actively sought through surveys and residents meetings. A range of activities that interest residents are made available. DS0000015838.V335096.R01.S.doc Version 5.2 Page 13 Survey’s elicited a range of responses relating to meals, activities and visitors. The following is a sample. Someone said that they would like ‘more variety, I like vegetarian food” Someone else said that they would like it better if they were ‘a little less hurried clearing away’ after meals. People say they ‘usually’ like the meals. Another person commented on the fact that they had a lot of visitors. Talking to residents during this visit found that they were satisfied and content with most aspects of the service provided and that it matched their expectations and preferences. Visitors are actively encouraged and made welcome. Some visitors were seen in the home at the time of this visit. Religious services are held in the home and arrangements can be made to attend church. Residents are supported to get out and about and trips out are arranged.. Menus seen are varied and nutritionally balanced. Catering staff are informed about residents’ dietary needs and food preferences. There is a choice of food at each mealtime and special diets are catered for. Residents mostly eat in the dining rooms but can have their meal in their bedroom if they prefer to eat alone. Meals are taken in an attractive dining room with properly set tables. Aids are available to help residents to continue to eat independently. Residents spoken to enjoyed the meals provided. Discussed with the manger that in order to further promote independence consideration should be given to the use of tureens and tea/coffee pots so that people who can are able to serve themselves. It is the case at breakfast and teatime that teapots are on the tables this should be extended to the mid day meal. Lunchtime was observed and residents were given enough time to complete their meal in a leisurely manner. DS0000015838.V335096.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are safeguarded from harm and any concerns raised are acted on. EVIDENCE: The home has complaints procedure that is clearly written and easy to understand. The procedure is given to every resident. An independent advocate can be made available to support residents in making a complaint. There have been no complaints since the last inspection. Residents spoken to know how to complain. They said it would be easy to talk to the management without any fear of repercussions. This suggests an open culture that allows residents to express their views and concerns in a safe and understanding environment. Feedback from resident surveys confirmed that they are aware of the complaints procedure and know who to talk to if they are not happy. One service user spoken to gave an example of an area of concern that she had discussed with the manager and the prompt action taken. Surveys also confirmed that residents felt that staff listened to what they had to say. There are policies and procedures relating to the protection of residents. Staff are provided with training and are aware of the need to report any allegations DS0000015838.V335096.R01.S.doc Version 5.2 Page 15 or suspicions of abuse to their manager. Staff know the importance of taking the views of residents seriously and responding to any issues raised. Management know the measures to take in relation to safeguarding residents if an allegation of abuse is made. Residents said they felt safe living at Red Lodge DS0000015838.V335096.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, safe and comfortable home. EVIDENCE: The home is very clean and smelled fresh. Aids and adaptations are provided and regularly serviced. Sampling of some health and safety records showed that fire alarms are tested regularly and staff receive fire training. A record of hot water temperatures is kept to ensure the delivery of safe hot water and prevent the risk of scalding. Since the home was last inspected other agencies have visited. The environmental health officers’ report found “high level of general cleanliness and good standards of food handling” DS0000015838.V335096.R01.S.doc Version 5.2 Page 17 Residents spoken to said that their bedrooms and the communal areas are kept clean. The management has a good infection control policy and they seek guidance from external specialists. The most recent training promoted good handwashing techniques. DS0000015838.V335096.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff are well trained to deliver a safe care service however some aspects of the recruitment process places service users at risk of harm. There is the potential to recruit unsuitable people. EVIDENCE: The rota shows that there is enough staff employed on each shift and especially at times of peak activity. Staff was observed responding quickly and appropriately to requests from residents and spent time talking to them. Residents spoken to say that staff are always available to provide appropriate support and that they never have to wait long for help. Residents said that they felt in safe hands. A high percentage of care staff have achieved National Vocational Qualification level 2 or above. Resident surveys showed that staff are always or usually available when needed. Comments received included “I am very happy here and I get the care I need. The staff work hard and do their best for us.” “The staff are very helpful.” And “ They always listen but are not able to act sometimes because they are busy.” DS0000015838.V335096.R01.S.doc Version 5.2 Page 19 Three staff files examined showed that the recruitment process is unsatisfactory and has the potential to recruit unsuitable people and thereby place residents at risk. Application forms are completed and an interview takes place. There was evidence that staff start work before appropriate references and Criminal Records Bureau checks have been received. All staff are employed subject to a probationary period. There is an ad hoc arrangement to sometimes include residents in the recruitment process. There is an induction programme that ensures new staff members are given the right information to be able to do their jobs well. Staff spoken to said that the on going training programme is good, providing them with the skills and knowledge to meet residents needs. The training programme includes all the mandatory training needed to meet resident’s basic needs such as lifting and handling, first aid, food hygiene, and health and safety. Specialist training provided includes dementia care, medication, infection control, visual impairment awareness and falls prevention. Discussed with the manager the need to provide catering staff with some training about the specific nutritional needs of older people. Staff supervision records seen confirmed that staff can identify their training needs. DS0000015838.V335096.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is managed in a manner that promotes and encourages residents to be involved in the running of the home. EVIDENCE: The manager is qualified and has many years experience of managing care services for older people. Discussions with the manager show that she has a clear sense of direction and understanding of best practice. She is committed to delivering a service that gives every resident the opportunity to live a fulfilling and meaningful life. The manager has good support from senior managers within the organisation who visit regularly. There are clear lines of accountability. DS0000015838.V335096.R01.S.doc Version 5.2 Page 21 Residents spoken to say that the manager is very approachable and easy to talk to. A member of care staff said that she felt well supported to do her job. The service uses a nationally recognised Quality Assurance System to maintain high standards of service delivery. Regular residents meetings, staff meetings and staff supervision promotes an open and transparent management style that operates in the best interests of residents. The minutes of residents meetings show that they actively participate in how the home is run. There is a nominated resident representative who attends the senior management committee meetings. Residents are also surveyed about different aspects of the service in order to get their point of view. The findings are analysed and wherever possible improvements made. The content of the staff supervision records examined is poor. Despite the document detailing the topics to be covered in supervision this was clearly not happening. Discussed with the manager and other senior managers visiting the home the reasons why supervision was not being done properly and ways in which improvements could be made. Staff may need additional training in this aspect of their work. Service users are encouraged to manage their own financial affairs. The service resists holding residents’ money for safekeeping. Residents /representatives make their own arrangements. Management work in partnership with a range of other key people e.g. health professionals, environmental health officers and the fire department to ensure continuous improvement of the service. The home works to a clear health and safety policy and regular safety checks are carried out. Staff training programmes includes Health and Safety training. Records are of a good standard and routinely completed. DS0000015838.V335096.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 4 2 X 4 DS0000015838.V335096.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation 19 Requirement At least two written references and a POVA/first check must be applied for and have been received before a decision is made to employ a care worker. Timescale for action 31/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP7 OP30 Good Practice Recommendations Care plans should be reviewed monthly. The outcome of the review should be recorded. Catering staff should receive training relating to the specific nutritional needs of older people. DS0000015838.V335096.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 DS0000015838.V335096.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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