Inspection on 13/04/06 for Red Roofs Care Home

This inspection was carried out on 13th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Red Roofs Care Home 30/05/07

Red Roofs Care Home 23/02/06

Red Roofs Care Home 05/12/05

Red Roofs Care Home 29/03/05

Red Roofs Care Home 05/01/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Red Roofs Care Home 35a Grange Road Newark Nottinghamshire NG24 4LH Lead Inspector Andrew Sales Unannounced Inspection 13th April 2006 10:00 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 Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 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. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Red Roofs Care Home Address 35a Grange Road Newark Nottinghamshire NG24 4LH 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) 01636 707 298 01636 678423 rgd@redhomes.com Mrs Margaret Jean Daniel Mrs Margaret Jean Daniel Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd February 2006 Brief Description of the Service: The home is purpose built and is within a couple of miles of the centre of Newark. There is a good level of adaptation to meet the needs of residents with a physical disability. The furnishings and lighting in communal areas are domestic in character. Residents are encouraged to bring in items of furniture from home to personalise their rooms. There are ample communal, bathing facilities and areas for social recreation. The grounds are tidy, secure and accessible to wheelchair users. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was conducted by A.J. Sales on 13 April 2006. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for residents and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting three residents and tracking the care they receive through review of their records and either discussion with them, the care staff and observation of care practices. The inspector also spent time talking to other residents in the home, a relative and two members of staff. Overall the feedback was excellent. Residents were happy to express their views about the home, they were positive in terms of the skills and attitude of the staff and of the overall standards of care, food, social recreation and the environment. What the service does well: What has improved since the last inspection? The majority of staff who previously did not have criminal record disclosure checks in place have now applied, thus working towards fully protecting residents. Further work to guarding radiators has been undertaken. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 6 Senior Care Staff roles have been introduced to the home, which share out the staff’s responsibilities and provide an additional layer of support to staff. Staff commented that although it is early days, they can see the benefits this will bring to promoting standards of care and communication. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 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 Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6. “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” Residents are fully assessed before moving in to the home. The home does not provide intermediate care. EVIDENCE: The records of three resident’s files were checked as part of this inspection. All of these contained an extended social work assessment, which had been obtained prior to their admission. All files contained assessments conducted by the manager, or deputy manager. All of the assessments were comprehensive and contained sufficient information to enable staff to ensure that they could meet the residents assessed needs. There were detailed action plans for care workers. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 9 Three residents were very keen to explain how living at the home has improved their quality of life in terms of care, company and social stimulation. They said they liked the homely environment and services available. Other residents present echoed these feelings. They all felt that prior to moving into the home that it was suitable for their needs and a place they wanted to live in rather than be placed in. A relative also spoke with the inspector and was very keen to support these comments. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. “Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service.” Residents receive a comprehensive assessment. Assessments are updated following a review. The home is able to meet the healthcare needs of it’s residents. Medication issues are managed appropriately. Residents are treated appropriately. EVIDENCE: Three care plans observed, were well set out and detail each area of need and an action plan is drawn up to meet this need. Risk assessments were well documented in each of the resident’s plans that were inspected. Particular attention is placed in the need to prevent pressure sores, falls and safe working practices. Daily records are well maintained by care staff and professional input from district nurses and GP’s is well documented. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 11 Evidence gained from speaking to residents and staff suggested the care planning process was accurate and outcomes satisfactory. Resident’s plans contain details of each individual’s health care needs, including tissue viability and continence risk assessments. There is evidence that people have been appropriately referred to health care professionals. Care plans viewed contained records of visits by district nurses, General Practitioners and other professionals. Healthcare professionals were observed visiting on the day. The inspector was informed that a number of doctors surgeries are used to ensure that the residents can register with a GP of their choice. Staff training records evidenced that medication training was provided for staff responsible for the administration of medication. The homes medication administration systems have been well maintained. There is a policy and procedures for receiving, recording, storing, handling, administering and disposing of medicines. The home is registered with the local pharmacist and support and advice obtained as and when needed. The pharmacist visits twice a year and conducts and audit of the homes medicines. Staff were observed during the visit interacting positively with individuals, all residents spoken with, reported staff provide a good standard of care and areas of concern would be discussed with the registered manager. All residents who spoke with the Inspector commented very positively on the conduct and attitude of the staff. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 “Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service.” Residents are supported to access daily activities and access the local community. Residents feel they retain much of their independence after moving into the home. Resident’s maintain contact with family and friends. The home provides ‘home cooked’ food, which is appealing to residents, with choices available. EVIDENCE: Residents spoken with, said they were happy with the level of activities within the home and outside. Resident’s commented that the philosophy of the home and the attitude of the staff enabled them to make choices and felt they were generally well respected. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 13 They also felt that staff were always willing to sit and talk with residents when they had time away from essential duties. The staff reported that they encourage residents to participate in events and outings. Planned trips and events are organised within the home. Staff spoken with, were well aware of residents individual preferences and respect residents choice on occasions where they chose not to participate in events. Residents described how the manager arranges for local artists to visit the home, who provide mainly musical entertainment. All residents said they enjoyed visiting entertainment arranged by the home. One resident and her daughter were extremely complimentary about the homes approach and how the residents dignity and respect were promoted through the homes management style and the culture and philosophy adopted by the staff team. Also the way that residents were supported socially whilst being mindfull of their independence. For example residents were able to celebrate their birthdays in a manner in which they chose. The staff and the cook would consult the individual over food and whether or not guests would be invited, there were options of a Sherry reception, individual birthday cakes and whether entertainment could be provided. Residents were also very pleased with outings arranged by the home in particular boat trips on the river trent.. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” Residents are now safeguarded by the homes complaints and adult protection procedures. EVIDENCE: The inspector observed a satisfactory complaints policy and procedure, on display. Records observed, are well maintained and very few complaints are received. Residents and relatives spoken with, stated they would raise concerns with the registered manager if they felt the need to. The inspector observed an appropriate Whistle Blowing Policy and a policy detailing Adult Protection Procedures. The homes policies and procedures for responding to suspicion or evidence of abuse, or neglect, are generally satisfactory. The home has comprehensive policies regarding resident’s money and financial affairs. Two staff interviewed said they had received training in adult protection issues and were fully aware of their responsibilities to safeguard older people. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,25,26. “Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service.” The home was clean and tidy at the time of this inspection. The home is generally well maintained. Residents live in comfortable surroundings; however further attention is required with regards to the requirements set at the previous inspection to ensure residents are fully protected. EVIDENCE: The home was observed as accessible, safe and well maintained. Residents spoken with feel it meets their individual and collective needs and is comfortable and homely. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 16 Rooms observed, are centrally heated and heating may be controlled in the resident’s own room. Lighting is domestic in character and includes a bedside light. Emergency lighting, which is an integral part of the fire alarm system, is provided throughout the building. Water outlets are temperature recorded and hot water signs posted throughout the home. The inspector tested one bath outlet, which registered 50.8 degrees, which exceeds the regulation 43 degrees. Although radiator guards are being installed to safeguard residents, many radiators are still exposed at a high temperature. Despite this being raised at the previous two inspections, progress has been slow and it does not appear to have been made a priority to protect residents. Whilst this work is being addressed, requirements have also been made in the past, to assess the risk to residents to determine if any of them were particularly vulnerable to scalding. This would have enabled the home to put additional measures in place to safeguard residents. This has also not been done and the commission is considering enforcement action. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 “Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service.” Staff are recruited and employed in suitable numbers. There are insufficient staff records at the home. Staff are trained in mandatory subjects required by this standard and for care specific support. Residents are now safeguarded by the homes recruitment practices. EVIDENCE: On the day of inspection there were sufficient numbers of care, domestic and kitchen staff on duty. The staffing levels meet requirements, with the current resident occupancy level of twenty nine. Residents said they never had to wait long for support and that it was timely and flexible. Four staff files were sampled at random. Some contained evidence of applications, interviews, pre-employment checks, but no one particular file contained all the evidence of this standard and in particular the evidence required in Schedule 2 of the regulations. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 18 However the commission recognises the quality and consistency of the staff at the home and does not consider this poses an immediate risk to residents. However a requirement is made to ensure all records are maintained in respect of regulations 18,19 and schedule 2. Of the staff files examined, they all contained some evidence of training in a number of health and safety subjects, dementia awareness, NVQ level 2, staff supervision and appraisal plans. However the staff training and induction program was not able to be appropriately assessed on this occasion. Both staff members spoken with, demonstrated a sound understanding of their roles and responsibilities and a great insight into the methods of promoting independence whilst supporting older people. From the comments and observations made, the staff team are held in high esteem amongst the residents for their commitment, attitude and support. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36, 38 “Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service.” The manager is highly thought of and has created a home where resident’s well being and dignity is a priority. The resident’s interests are key to any decisions made at the home. Residents are consulted over issues in the care home and their safety and well being are put first. Staff are appropriately supervised. Health and Safety issues are generally well managed. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 20 EVIDENCE: Residents said they felt the home was well run and the management team were always on hand for support and advice. Staff spoken with, confirmed that they felt supported by the manager and that they are approachable to discuss any issues. The owner/manager of the home is a registered nurse. She has many years of experience and knowledge to manage a care home and is available day and night should she be required. Staff spoken with spoke highly of the manager and deputy manager and stated they felt well supported within their job role. Residents and in particular one relative, stated that the home’s success is down to the manager and her approach. She said that the manager has developed a culture of putting residents at the forefront of everything that is done and staff have adopted this same approach. A relevant policy with regards to the safe keeping of resident’s personal allowances is in place and followed. Resident’s accounts were not checked as part of this inspection. The Staff confirmed they receive regular supervision and attend regular team meetings. Supervision records were observed. Residents stated that they felt they were consulted about day to day issues. Some records of appraisal were viewed. Some staff files contained records of supervision and appraisal. Staff spoken with also supported this process. Some staff files observed evidenced that staff have undertaken training in some mandatory health and safety subjects. Staff spoken with, were aware of health and safety procedures and commented positively on the training provided. Risk assessments were observed on individual files and are in place for the building and individual residents. Records for Health and Safety monitoring and the servicing of systems and appliances were inspected on this occasion and were found in general, to be up to date. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 21 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 3 X 3 Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP25 Regulation 13 (4,a,c.)23 (2)(p) Requirement Ensure Radiators are guarded or have low surface temperatures. This is an outstanding requirement from the 5th December 2005 and 23 February 2006 and must be addressed to avoid enforcement action. Radiator Guards. Risk assessments are required to be in place to ensure residents are fully protected. Ensure risk assessments are carried out to identify potential scalding risks from hot water temperatures. This is an outstanding requirement from the 12 December 2005 and 23 February 2006 and must be addressed to avoid enforcement action. Timescale for action 23/04/06 2. OP25 13 (4,a,c.)23 (2)(p) 13. (3)(4)(a)( c) 17/04/06 3. OP25 17/04/06 4 OP29 19(1,b) Sch 2 All staff employed are required 23/05/06 to have all listed documentation as stated in schedule two of the Care Homes Regulations 2001 on file. Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Red Roofs Care Home DS0000008740.V288927.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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