Inspection on 30/09/08 for Red Lodge

This inspection was carried out on 30th September 2008.

CSCI found this care home to be providing an Good service.

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 26/06/07

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 17/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Red Lodge Hawthorn Terrace New Earswick York YO32 4ZA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Catherine Paling     Date: 3 0 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Red Lodge Hawthorn Terrace New Earswick York YO32 4ZA 01904762111 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Susan Veitch Type of registration: Number of places registered: Joseph Rowntree Housing Trust care home 42 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 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 people on two floors for personal and social care. Nursing care is not provided. The single rooms are spacious and have en suite facilities. There are also communal lounge and dining facilties. There is easy access to a well tended and safe garden with plenty of seating. The premises also includes 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 people and or their representatives. A copy of the CSCI report can be obtained from the manager. At the time of this visit fees range from £415.85 per week to £1802 per calendar month. Care Homes for Older People Page 4 of 28 Over 65 42 0 Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced visit by one inspector for one day. We were at the home from 09:30 until 17:40 on the 30th September 2008. An expert by experience was also involved in the inspection for part of the day. The last key inspection for the home was on 26th June 2007. An ‘expert by experience’ is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. Care Homes for Older People Page 6 of 28 The purpose of our inspection was to make sure the home was operating and being managed for the benefit and well being of the people who live there and in accordance with requirements. Before the inspection we looked at accumulated evidence about the home. This included looking at any reported incidents, accidents and complaints. We used this information to plan the visit. We looked at a number of documents during the visit and visited all areas of the home used by the people who live there. We spent a good proportion of time talking with the people at the home as well as with the manager and the staff. We asked the home to provide some information before the visit by completing an Annual Quality Assurance Assessment (AQAA). We completed an Annual Service Review for the service in June 2008 and as part of that process we sent survey forms to the home providing the opportunity for people to comment on the service, if they wish. Information provided in this way may be shared with the provider but the source will not be identified. A small number of surveys were returned and some of their comments are included in the report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 28 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with enough information to enable them to make an informed choice about the home. The admission process includes pre-admission assessments and trial visits are offered to make sure that peoples care needs can be met. Evidence: Everyone planning to move into the home has their needs assessed by a senior member of the care staff before they move in. This is to make sure that their specific needs can be met at the home. Following admission a more detailed assessment is completed over the first two weeks at the home The assessment tool helps to identify those areas of care where support is needed from care staff and a care plan is written with detail of the support needed. People are encouraged to visit the home themselves to help them decide whether they want to move into the home. In many cases relatives visit on their behalf. The Care Homes for Older People Page 11 of 28 Evidence: manager and her deputy are committed to making sure that people have as much information as possible. As part of this they have recently started to take a laptop computer with them when they go and assess people’s needs. They have taken a number of photographs of the home and gardens, including corridors, bedrooms and communal areas that they can show people on the laptop. One recently admitted person said that she had found this very helpful. This person and her relatives spoke highly of the well managed admission process saying that: Staff went through everything and that she felt that she had enough information. Staff were very kind and understanding and they really look after you. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans contain enough information so that staff can look after people properly. Staff respect the privacy and dignity of people living at the home. People are protected by safe medication practices. Evidence: There are individual files containing admission and contract details, which are held seperately. However, peoples care records are kept together in one large file. The manager recognises the need for individual files but says there is a storage problem. Keeping peoples personal information together in this way could be a breach of data protection. The manager needs to look at this again and make arrangements for individual files and safe storage of records. We looked in detail at the care of 3 people who live at the home. We saw that they all had care plans that gave staff instructions on how to look after them. The information in the care plans was very brief and consisted largely of a list of tasks for staff to follow. They were not person centred meaning that there was very little personal detail Care Homes for Older People Page 13 of 28 Evidence: about how people wanted to be cared for. However, staff do know the people they care for very well and understand their care needs. The deputy manager is responsible for co-ordinating the care records, and makes sure that information is recorded. Information is sought from all sources including ancillary staff who are encouraged to share any information they might have about anyone living at the home that might contribute to positive outcomes. A detailed assessment of abilities is reviewed every three months for everyone and is used to identify areas where support is needed. We saw that risk assessments are completed for the risk of falls and any risks of manual handling and moving. Nutritional risk assessments are not used, although people are weighed monthly. One person who was at some nutritional risk had a brief care plan in place to make sure that they had additional support. People have their healthcare needs met by visiting General Practitioners and community nurses and chiropodists. We saw records of their visits and of hospital visits. People said: They are good here Bring you anything you want Very kind When people develop acute problems, such as a chest infection, a separate sheet is completed to detail the additional care and support needed. This had not happened in the case of one person who had been poorly with a chest infection, although this person was now on the way to recovery. Medication is stored in each person’s room in a lockable cabinet and people are supported to self medicate wherever possible following completion of risk assessment. The home has good support from their local pharmacy who arranges repeat prescriptions on a weekly basis liaising with the home and the GP surgeries. All medication is checked into the home and returns are also recorded. All care staff involved in giving out medication have to complete a number of competencies and visit the chemist before they administer medication unsupervised. There is also an annual review for all involved. The medication administration record (MAR) sheets have clear photographs of people to help staff to clearly identify that they are giving medication to the right person. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported in maintaining contact with their family and friends. However, less able people are at risk of becoming isolated and may not have enough to occupy their time. Evidence: We were accompanied by an expert by experience who we asked to find out what daily life is like for people living at the home, and whether they feel they are listened to and are supported to live the life they want. We chatted with several people and it became clear that most tend to stay in their own room, apart from main meal times. The manager said that people do use the many little seating areas around the home to socialise but this was not seen during the visit. No one could recall taking part in any activities, although they knew that they had a list in their Welcome Packs. Staff said that people could stay in their room, which most of them preferred, or sit in the lounge area, or join in the activities. The frequency and range of activities seemed to depend on staff availability or volunteer input. There is an activities room where there was evidence of the crafts some people had made. This Care Homes for Older People Page 15 of 28 Evidence: was not a particularly inviting room and there were no easily accessible games or puzzles. People were not using the conservatory lounge overlooking the garden on the day of the visit. We discussed with the manager ways that people could be encouraged to socialise. None of the people we spoke with had made a particular friend within the care home. One new person said that if people were encouraged to linger after meals that this might be a way for people to get to know others and make friends. We spoke to two recently admitted people, one was very out-going and had already made their own mark. The other person, rather quiet and shy, had things they wanted to ask about but hadn’t yet found the courage to do so. We felt that there was a risk that some less able people could become lonely and isolated, with little stimulation, and simply accept that as normal. An activity sheet is included in the welcome pack and includes daytime and evening events. Activities are dependant on the availability of staff or volunteers. The programme shows quite a limited range of activities. For example, bingo, scrabble, carpet bowls and exercise or keep fit classes. One person told us that there used to be concerts but that there was not much to do now. It seems that some people are able to occupy themselves and can go out but those less able and more dependant people are at risk of becoming isolated. There needs to be more encouragement to stimulate and encourage socialisation for those more dependant people. The arrangement of activities and stimulation should be formalised and not solely dependant on volunteers or care staff having some spare time. There had been an end of summer barbeque and social event recently, which was enjoyed by many of the people who live at the home as well as their relatives and the staff. The more able people also have access to events in the village and a monthly paper from the village tells them what’s on, for example, church services. There are links with the local school with an annual presentation of the Red Lodge Shield of Achievement as well as the school choir and celebrations such as Harvest Festival. Once a week there is the Philosophy Group, which encourages a two-way learning process between children and the people living at the home with talks on a variety of subjects. There is a small hairdressing room and male and female hairdressers visit the home Care Homes for Older People Page 16 of 28 Evidence: very regularly. We talked to the manager about various opportunities for socialising, making sure that people knew what was on and getting the balance right between encouraging independence and the risk of isolation. Breakfast is served in bedrooms and other meals are served in the dining room and people are encouraged to socialise at mealtimes. However, we felt that people could have been encouraged to linger after the meal to chat over a cup of tea. People still have the option to have their meals in their rooms. There are 3 to 4 weekly menus that are being reviewed and include a choice of main course and of dessert. The three course main meal is at lunchtime with a lighter evening meal, still with choice. There was evidence of good care and support to people and their families in a letter written recently to the home: Wonderful to see mum display her sense of humour again and that was down to your good care. You always treated her with respect and dignity and showed Kindness, patience, compassion and understanding Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel that their concerns will be taken seriously. People feel safe at the home. Evidence: There is a complaints procedure in place at the home but it is not included in the Welcome Pack. Complaints are referred to in the information pack but the only guidance is to talk to the manager or otherwise to look at the complaints procedure on the notice board. The complaints procedure should be made available to everyone and should be included in the welcome pack. Information from the home in the AQAA says that they have not received any complaints over the last 12 months. We received information about the service September 2007, which was sent to the provider for investigation under their procedures. It was properly investigated and the complainant received a written response from the provider. The provider also met with the complainant as part of the attempt to resolve the issues. Safeguarding training is ongoing for staff and they have access to local procedures and also to a whistle blowing procedure. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, comfortable and well maintained environment. Evidence: Information in the AQAA states: Residents encouraged to see the home as their own, keys to own rooms, bring their own furniture, Residents involved in decisions re décor, Single en suite rooms, Selection of communal rooms, Recreation room available for family parties and celebrations. Overall the home is in need of redecoration and some areas were looking a little shabby. However, there refurbishment plans are in place and redecoration work is starting. The individual rooms are spacious with small kitchenettes and en suites. There is a programme underway to replace the baths in the en suites with showers. Plans are also underway for the redecoration of corridors and people have been involved in choosing the colour scheme and the new carpet. There is a large communal dining and lounge area with folding doors to split into two separate rooms, if needed. Comfortable seating is placed strategically around the home. The arrangements and layout of the home serves to promote the independence Care Homes for Older People Page 19 of 28 Evidence: of people living there. There are large well tended and accessible gardens with plenty of seating. The rose garden is particularly attractive and was used recently for a barbeque. There is a separate laundry with good infection control procedures in place. Table linen is washed in a separate washer. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by a competent and well trained staff team. People are protected by robust recruitment practices. Evidence: Information in the AQAA states: 88 staff qualified to NVQ level 2 and above. Low staff turnover Sufficient staff at all times Internal development as well as external training There is an established and stable staff team working at the home providing consistency and continuity for the people living there. The care staff are supported by an ancillary staff team although they do have laundry duties and cleaning duties at weekends. There is a reduction in the number of care staff on duty after 14.30 from 6 to 4. The affect of this reduction should be kept under review as it may result in people not having choice about some aspects of their care and the provision of social activities and outings. Staff are well trained with the greater majority having achieved a National Vocational Qualification (NVQ) in care at Level 2. Senior carers are encouraged to pursue further training and we spoke to one senior carer who is working towards an NVQ in care at level 4 in care. Information displayed in the home also provided evidence of the range Care Homes for Older People Page 21 of 28 Evidence: of training available to staff to make sure that they know how to look after people properly. Original recruitment records are held centrally. We spoke with a newly appointed member of staff who told us about the recruitment process that included all the required checks. Photocopies of documents were available. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home is well organised and practices promote and safeguard the health safety and well being of people living at the home. Evidence: The manager provides continuity and stability to the staff and the people living at the home. She is well qualified and has been manager at the home for several years. She is supported by her deputy who is also well qualified and experienced. Information in the AQAA states that the quality assurance systems have improved over the last twelve months. As part of these improvements there is a new role within the organisation of Quality and Compliance Officer. We were told that there is work going on to improve communications with people living at the home and their relatives. The plan is for two meetings a year with the provider and representatives of the organisation. The autumn meeting will concentrate Care Homes for Older People Page 23 of 28 Evidence: on quality assurance issues and the springtime meeting will allow the opportunity for people to discuss fees, which are reviewed each year. The autumn meeting is planned for 21st October 2008. A meeting was also held 29th September 2008 with people to discuss catering arrangements. Changes to the time of the lunchtime meal were agreed, from 12.15 to 12.30 for four weeks initially. People are surveyed, as are relatives and staff. The manager said healthcare professionals are not currently surveyed. Meetings are held to discuss outcomes. There is a comprehensive system of auditing to help the manager monitor the services and facilities at the home. These include health and safety audits of the environment, medication and care plan audits. Staff performance is monitored by means of an established programme of formal supervision. Appraisals are completed annually for all staff. The home does not manage any personal allowances. The manager said that sometimes families bring small amounts of money for hairdressing or chiropody. This money is not recorded anywhere and the manager was advised that it should be recorded, with two signatures, when it is brought into the home and when it is used. Receipts of any transactions should also be kept. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Work should be undertaken to develop person centred care plans. This is so that people can be satisfied that they will be looked after in the way they want. Consideration should be given to the introduction of nutritional risk assessments. This is so that peoples nutritional needs are not overlooked. The provision and arrangements for activities and stimulation should be reviewed. This is to make sure that less able people are not put at risk of becoming isolated. The complaints procedure should be made available to everyone. This is so that people are clear about how to any raise concerns if they need to. The involvement of staff in non caring duties should be kept under review to make sure that they are not taken away from care tasks. This is to make sure that people have as much choice about their care as possible. Consideration should be given to seeking the views of healthcare professionals. This will help in the ongoing monitoring of the effectiveness of the service provided. Records should be kept of any money kept on behalf of people living at the home. Receipts of any transactions should also be kept. This is to make sure that systems are Page 26 of 28 2 8 3 12 4 16 5 27 6 33 7 35 Care Homes for Older People clear and transparent. Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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