CARE HOMES FOR OLDER PEOPLE
Red Roofs Care Home 35a Grange Road Newark Nottinghamshire NG24 4LH Lead Inspector
Andrew Sales Key Unannounced Inspection 30th May 2007 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.V337629.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. Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 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.V337629.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 13th April 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 people with a physical disability. The furnishings and lighting in communal areas are domestic in character. People 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. The fees for this service range between £364.00 per week £429.00 to per week. Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection process commenced on 30 May 2007 and an unannounced visit to the site was conducted on 6 June 2007 at 10.00am. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people 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. Where possible, we include evidence from other sources, notably District Nurses and Social Workers. We also use information gathered throughout the year, to support our judgements. This may include notifications from the provider, complaints or concerns and the pre-inspection questionnaire, which the provider is required to complete prior to a visit to the service. On this occasion we did not receive the pre-inspection documentation, which should be completed by the provider prior to inspection. We were therefore unable to include any evidence from resident’s surveys. The primary method of inspection used during the visit to this service was ‘case tracking’. This involved selecting three people and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. We also spoke with two other people and one relative, who were able to give us their views about the service. We also spoke with four members of the care staff who were also very helpful. We spent part of the day discussing records, documents and policies with the deputy manager. All of the key standards were inspected on this occasion. What the service does well:
Red Roofs provides a domestic and comfortable environment, which is very well maintained and furnished. The manager and staff are very committed to providing good standards of care for the people living there. The food is well thought of and people feel respected and enabled to socialise in a manner that is comfortable for them. Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 6 The gardens are well maintained and provide a pleasant view from the inside the home and a nice place for people to relax in. The staff strive to provide consistent and good standards of care and the service continues to comply with the National Minimum Standards. All of the people spoke highly of the staff saying, the staff are very helpful and kind. Some people stated that the food was “lovely” and that they liked the social activities and stimulation provided. Relatives are kept well informed, are supported by the staff and managers and said they were ‘always made welcome’. The people feel they are consulted on matters relating to the running of the home, and receive regular newsletters, which details any forthcoming events and news. The people spoke positively about their private and communal accommodation. Some new people said they enjoyed sitting in the quiet lounge at the looking out across the gardens and fields beyond. 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.
Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 8 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.V337629.R01.S.doc Version 5.2 Page 9 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): 3,4,5,6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are fully assessed before moving in to the home and are confident the service will meet their needs. The home does not provide intermediate care. EVIDENCE: All of the files we looked at contained, where appropriate, an extended social work assessment, which had been obtained prior to their admission. All files contained care plans conducted by the manager, or deputy manager. All of the assessments were adequate and contained sufficient information to enable staff to ensure that they could meet people’s assessed needs. There were detailed action plans for care workers. All of the people 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. They all
Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 10 felt that prior to moving into the home that it was suitable for their needs and a place they wanted to live in. A relative we spoke with also supported these feelings. People also told us that they had been able to stay at the home prior to moving in, one had stayed a twice before deciding to move here. Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 11 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): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal care needs of people are planned for and met by knowledgeable and well-trained care staff who strive to make sure people using this service are treated with respect. EVIDENCE: The assessments and plans of care we looked at were well set out and detail each area of need with action plans for staff. Risk assessments were also present and well documented. Attention is placed in the need to prevent pressure sores, falls and to promote safe working practices. Daily records are well maintained by care staff and professional input from district nurses and GP’s is well documented. We saw evidence that moving and handling assessments are now reviewed. Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 12 People told us the care planning process was accurate and helped staff to respond to any changes in people needs. Individual’s care plans contain details of each person’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 contained records of visits by district nurses, General Practitioners and other professionals. Healthcare professionals were observed visiting on the day. We were told that people can register with a GP of their choice. The homes medication administration systems are 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 and conducts and audit of the homes medicines. We were told that the manager and deputy managers have all attended updated medication training. Staff were observed during the visit interacting positively with individuals. People told us that staff provide a good standard of care and areas of concern would be discussed with the registered manager. People also commented very positively on the conduct and attitude of the staff. They said ‘the staff are wonderful, they are always on hand to help and they are always polite’. One relative said ‘ the home is excellent, the staff are wonderful and welcoming and take time to talk with her mother’. She also said the food is good and the managers are ‘extremely approachable and always willing to talk over things and listen’. Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 13 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): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People feel they retain much of their independence after moving into the home and maintain contact with family and friends. People are supported to access daily activities and access the local community. EVIDENCE: People told us they were happy with the level of activities within the home and outside. They 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. They also felt that staff were always willing to sit and talk with people when they had time away from essential duties. People told us that games and stimulation are provided regularly. Staff described how they encourage people to participate in events and outings and take time to sit with those who are less able to communicate. People described
Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 14 boat trips along the river Trent on which they take a picnic and other events which are organised within the home. Staff spoken with, were well aware of individual preferences and respect people’s choice on occasions where they chose not to participate in events. People described how the thier dignity and respect were promoted through the homes management style and the culture and philosophy adopted by the staff team. People told us they thought the food was good and there was always choices at mealtimes. They said they can have hot food, soup, salad or sandwiches in the evening and were happy with what was available. We looked at the kitchen facilities, where appropriate cleaning schedules were in place and fridge and food temperatures were monitored and recorded. The cook described cleaning and maintenance schedules and how they catered for different tastes and diets. We were shown how birthdays are catered for. People are able to celebrate their birthdays in a manner in which they choose, for example a party or reception. The staff and the cook would consult the individual over food and whether or not guests would be invited, individual birthday cakes provided or whether entertainment could be provided. Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 15 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): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are safeguarded by the homes complaints and adult protection procedures. EVIDENCE: We looked at a satisfactory complaints policy and procedures, which are displayed throughout the home. We looked at complaints records. The service has not received any since the last inspection. The commission has not received any complaints in relation to this service. People told us that they would raise concerns with the registered manager if they felt the need to. We looked at 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. Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 16 Two staff told us they had received training in adult protection issues and all spoken with were fully aware of their responsibilities to safeguard older people. Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 17 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): 19,20,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and decorated. People enjoy the comfortable and well furnished communal and bedroom areas. EVIDENCE: We looked at most parts of the home and found it to be extremely well furnished and maintained which people said they liked very much. We saw a suitable number of assisted bathrooms and toilets with full access for people with a disability. There are a number of mobility aids in use around the
Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 18 home and the staff were able to tell us how individuals use them with staff support. People told us how they enjoy looking out onto the gardens and fields to the back of the home. They said the gardens are a ‘nice place to relax in the better weather’. We looked at the laundry area, which is appropriately equipped. None of the people had any concerns about their clothes being cleaned or going missing. We saw appropriate cleaning schedules in operation throughout the home including the kitchen and laundry. There are no malodours present in the home and people said how important this was to them. Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 19 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): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by well-trained and competent staff. EVIDENCE: People told us that there were usually adequate numbers of staff in order to meet their support needs, and commented that the staff team are “wonderful” and “always willing to help”. We were also told that people did not feel rushed and staff were never in a hurry. Staff files all contained some evidence of training in a number of health and safety subjects, dementia awareness, National Vocational Qualification (NVQ) level 2, staff supervision and appraisal plans. Files also contained evidence of applications, interviews, pre-employment checks and Criminal Records Bureau (CRB) checks. The staff demonstrated a sound understanding of their roles and responsibilities and a great insight into the methods of promoting independence whilst supporting older people. They told us that they had
Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 20 attended numerous training courses and have regular updates in all of the mandatory Health and Safety training courses. From the comments and observations made, the staff team are held in high esteem amongst the people for their commitment, attitude and support. There was evidence that staff receive supervision on a regular basis and staff members did confirm this during our discussions. Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 21 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): 31,32,33,35,36,37,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed well and there is leadership, guidance and direction to staff to ensure people receive consistent quality care. This results in practices that promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: People told us 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.
Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 22 Staff spoken with spoke highly of the manager and deputy managers and stated they felt well supported within their job role. People stated that the home’s success is due to the culture of putting people first and respecting their choices. A relevant policy with regards to the safe keeping of resident’s personal allowances is in place and followed. We checked one resident’s cash held with their accounts records, which were accurate. The staff confirmed they receive regular supervision and attend regular team meetings. Supervision records were observed. People stated that they felt they were consulted about day to day issues. Staff files showed that they have undertaken training in mandatory health and safety subjects. Staff spoken with, were aware of health and safety procedures and commented positively on the training provided. We were shown numerous documents and records, which have been introduced or improved. These relate to the safety and well-being of people and assist in the improved management of the service. Risk assessments were observed on individual files and are in place for the building and individual people. 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.V337629.R01.S.doc Version 5.2 Page 23 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 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X 3 3 3 3 Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP25 Good Practice Recommendations Radiators. Ensure remaining measures are put in place to ensure people are fully protected. Red Roofs Care Home DS0000008740.V337629.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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
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