Inspection on 03/04/07 for Red Rose Care Home

This inspection was carried out on 3rd April 2007.

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 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 Rose Care Home 02/04/08

Red Rose Care Home 06/03/06

Red Rose Care Home 02/02/06

Red Rose Care Home 22/03/05

Red Rose Care Home 21/09/04

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 Rose Care Home Brockton Avenue Farndon Newark Nottinghamshire NG24 4TH Lead Inspector Key Unannounced Inspection 3rd April 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 Rose Care Home DS0000024657.V334517.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 Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Red Rose Care Home Address Brockton Avenue Farndon Newark Nottinghamshire NG24 4TH 01636 673017 01636 678423 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) Mrs M J Daniel Linda Claire Gee Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44) of places Red Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Named Service user to be accommodated for TI category. There after the home’s registration reverts back to accommodate up to 44 service users within the OP category. Service users shall be within category OP Date of last inspection 27th June 2006 Brief Description of the Service: Red Rose Care Home is a 44 bedded home for older people including nursing. It is a purpose built home in the residential area of Farndon village. Farndon is situated just off the A46, three miles south of Newark and there is access to a local bus route into the town of Newark if required. There are 36 single rooms, 10 of which have en-suite facilities; there are also 4 double rooms. There are communal lounges, dining areas, bathrooms and toilet facilities. The home is domestic in character and well maintained. The grounds are well maintained and service users are able to access these areas. There is also a reasonable size car park. The current weekly fees for the service range from£360 - £427, additional payments may also be applied; these would be discussed on enquiry. These fees do not include hairdressing and chiropody services. The previous report is made available on request. Red Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was undertaken by an inspector reviewing all the previous inspection records available, looking at information provided by the manager about Red Rose and by undertaking a visit to the service with the inspector using a method called “case tracking.” “Case tracking” involves identifying individual service users who currently live at the home and tracking the experience of the care and support they have received during the time they have lived there. The inspector also checked that information provided by the manager matched individual experiences of service users living at the home by talking with them and observing the care received. Six service users and two visitors were spoken with, all of them expressed that care was at a good standard and staff were very kind and attentive. General house records and staff records were also looked at to ensure these were maintained and provided positive outcomes for service users. Two members of staff were spoken with and were able to discuss service users needs and support required. What the service does well: What has improved since the last inspection? The main entrance and upper floor lounge have been redecorated offering a comfortable environment for service users. Red Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 6 An ongoing process of refurbishment and upgrading of equipment is taking place to ensure service users live in a well-maintained environment. The quality assurance programme continues to develop ensuring service users live a quality life in a home, which is run in their best interest. Plans of care have continued to develop to ensure that all support required is documented ensuring service users needs are fully met. Risk assessments and audit trails for the use of restraints have been developed to ensure service users are protected and their rights are ensured. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Red Rose Care Home DS0000024657.V334517.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 Red Rose Care Home DS0000024657.V334517.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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are assured their needs will be assessed and met prior to moving into the home. The service does not offer intermediate care. EVIDENCE: The manager said that prospective service users are visited in the community prior to admission and a preadmission assessment completed. Service users files contained a preadmission assessment. Service users and relevant others may visit the home and spend time there prior to making a decision to enter the home. One service user spoken with discussed the events that took place prior to their admission and confirmed the above takes place. The service does not offer intermediate care. Red Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users health and personal needs are met, however service users remain at a degree of risk due to underdeveloped risk assessments. Service users feel they are treated with respect and their right to privacy is upheld. EVIDENCE: Service users undergo various assessments such as manual handling, infection control, nutrition and the activities of daily living. Information gained forms the plan of care. Plans of care in place covered all identified needs and support service users required. With regard to service users personal choices and preferences information was limited, however plans of care did state to offer choices and ensure service users were involved in decision-making. Risk assessments were in place with regards to entrapment and the use of bedrails and lap restraints. Within one plan of care where a service user had experienced an episode of choking, no risk assessment had been made available, however this had been noted in the care plan for nutritional needs. On talking with staff they were able to explain the plans in place to prevent Red Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 10 choking and how they would act should this occur. Within another plan of care where a service user was at risk of falls and had epilepsy no risk assessment was in place, again staff were able to explain how they would act to reduce these incidents and deal with them should they occur. Risk assessments were discussed with the manager and provider, both have now attended a course on risk assessments and stated that they will action these areas immediately. Staff spoken with were able to discuss service users needs and how they are supported in meeting these. Service users spoken with said that their needs were fully met. Within plans of care there was evidence to show that service users have access to specialist services, equipment and aids. During the tour of the home various forms of equipment such as hoists and aids such as mattresses and cushions were seen. Two GP’s were seen to visit the home during the day. One service user spoken with said that they can see the doctor at any time. The manager discussed the services available to the home and explained that a new support system from the community care team had been put into place. This offers additional support for service users with dementia care needs and also when referrals to specialist services are required. Medication records and procedures were examined. On one service users medication record the prescription did not match the medication record, this had been changed the previous day by the GP. The registered nurse altered this immediately. Hand written entries were not signed by two members of staff to show that these had been checked as correct. All other records such as medication signed into the building and medication returned or destroyed were available. All registered nurses have undertaken distance-learning courses for the safe administration of medicines. The manager was observed to administer the lunchtime medicines to service users in accordance with policies and procedures. Screening available within double rooms. Staff were observed to knock on doors prior to entering and also treat service users with respect. Service users and visitors spoken with said that staff were kind and caring and respectful at all times. Red Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are enabled to exercise choice and control over their lives and find the lifestyle experienced in the home matches their expectations and satisfies their needs. EVIDENCE: An activities coordinator offers various activities three times a week. These include arts and crafts, games, flower arranging, sing a longs and more. Various pieces of artwork that had been done by service users were seen around the home. One service user was observed to give their relative an Easter card they had been assisted to make, which she said she had enjoyed doing. One relative spoken with confirmed that various activities were on offer should any one wish to join in. Another service user spoken with said that they enjoyed the activities on offer especially the flower arranging. The manager said that local vicars offer Holy Communion to service users on a regular basis and if service users wished to attend church this would be facilitated, staff spoken with confirmed this. Both service users and staff spoken with said that the routine of the home was flexible and they may choose how they spend their time. Red Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 12 There are no restrictions on visiting. Two visitors spoken with said that they may visit at anytime and staff always made them welcome. Visitors were seen to come and go freely throughout the day. Evidence of a good relationship between staff and visitors was evident. Whilst undertaking training staff have covered issues with regard to equality and diversity of service users. Staff spoken with were able to discuss how they ensured service users were respected and treated as individuals and their life experiences valued. Service users spoken with said that staff listen to them and they feel that they are treated as they should be. The provider said he is looking in to these issues further in respect of service users who have dementia care needs; to ensure that all aspects of offering a quality life and ensuring equality and diversity is maintained. A wholesome and appealing menu is on offer. Following the review of the quality assurance questionnaires more choices have now been added to the menu. Service users spoken with said that food was at a good standard and was plentiful. Staff spoken with were able to discuss special diets and service users needs and preferences. Records such as temperature controls and cleaning rotas were seen; these were up to date. Red Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 13 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and relevant others are assured that their complaints will be listened to, taken seriously and acted upon. Service users are protected from abuse. EVIDENCE: There have been two complaints received since the previous inspection. One regarding a service user wandering, another from a member of staff in regard to a service users attitude towards them. Both incidents had been dealt with appropriately and resolved. Staff spoken with were able to discuss how they would handle a complaint should it be received. Service users and visitors spoken with expressed no complaints. All staff have Criminal Record Bureau checks in place. Twenty-five members of staff have undertaken training in the protection of vulnerable adults; additional staff have also covered this whilst undertaking the National Vocational Qualification (a nationally recognised work and theory based qualification NVQ). Staff spoken with were able to discuss how they would recognise abuse and the action they would take if they felt it was occurring. Red Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a clean, pleasant and hygienic home, which is safe and well maintained. EVIDENCE: Evidence of ongoing maintenance and refurbishment was seen during the tour of the home. The main entrance and the dining room upstairs have been redecorated. Some bedroom furniture has been replaced and the manager said there are plans to continue to roll this out as well as purchasing new beds. The gardens were well maintained. The home was clean and tidy. Hand washing facilitates were available throughout the home. The majority of staff have been trained in infection control. Red Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are in safe hands at all times; trained and competent staff meet their needs. EVIDENCE: Staff duty rotas were seen which showed that two registered nurses and eight care staff are on duty throughout the day. During the night there are two registered nurses and two care staff. The duty rota showed that skill mix was considered. Staff spoken with said that sufficient staff were on duty to provide a good standard of care. Service users and the visitors spoken with said that staff were available when needed. The manager said that the induction programme remains unchanged. One new member of staff spoken with said that they were currently undergoing an induction. Another member of staff was seen being given fire instruction as part of their induction. One member of staff has attained the National Vocational Qualification (a nationally recognised work and theory based qualification) level 3 and 2 are working towards this qualification. Five members of staff have attained NVQ level 2 and five are working towards this qualification. Four staff personnel files were seen, all contained the required documentation. Red Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 16 Each staff member has an individual training plan, which is reviewed on a regular basis; evidence of this was seen in staff personnel files. Staff continue training in all compulsory areas. Staff spoken with were able to confirm this and said that they felt supported in their development. The manager is looking into additional training in first aid for staff in the near future. Red Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a home that is well managed and run in their best interests. Service users rights and interests are safeguarded and their health, safety and welfare promoted and protected. EVIDENCE: The manager is registered with the Commission for Social Care Inspection. She has completed the Registered Managers Award and a course in risk assessment. She is now doing a course about a person centred approach to service users with dementia and also a diploma in business practice. She stated that she felt very supported by both the proprietor and the staff. Both Red Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 18 staff and service users spoken with spoke highly of the manager and the running of the home. Annual questionnaires have been sent out to service users and relatives. The results have been collated; good practice areas and areas for improvement have been highlighted. The provider said that several meetings have been held to discuss the findings and an action plan is in the process of being worked towards. Evidence of this occurring was the change in choices of the main menu. The provider also stated that a performance review of the home had been undertaken. One relative spoken with said that they had completed a questionnaire about the home. Four service users personal accounts were seen, when checked these corresponded with the accounting record. Receipts were available for money spent and staff had signed all transactions. The administrator said that service users may access their money at any time. No employee is responsible for service users finances. Servicing and maintenance certificates such as the gas, waste control, portable appliance testing and fire systems were seen. The mains electric had not been tested since 1998. The manager said that the hoist had been recently tested; work sheets were available to confirm this. The fire alarm testing had been completed however there were three incidents this year where there had been more than 7days between tests. Emergency lights had been tested on a monthly basis. Accident records were available within service users and staff personnel files, relevant information was available. Red Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 19 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 X 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 3 X 3 X 3 X X 2 Red Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 20 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 OP7 Regulation 13(4,c) Requirement Additional risk management plans must be implemented where service users have been identified as being at risk to ensure they remain safe. Implement additional checks to ensure that changes in service users medication is recorded to ensure service users are fully protected. Timescale for action 10/05/07 2. OP9 13(2) 10/05/07 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 Refer to Standard OP9 Good Practice Recommendations Handwritten entries on service users medication charts are signed by two members of staff to show that these have been checked and are correct. Red Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 21 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Red Rose Care Home DS0000024657.V334517.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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