CARE HOMES FOR OLDER PEOPLE
Redannick House Redannick Lane Truro Cornwall TR1 2JP Lead Inspector
Lynda Kirtland Unannounced 18 August 2005 12:45 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 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. Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Redannick House Address Redannick Lane Truro Cornwall TR1 2JP Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01872 276889 01872 240903 Cornwall Care Limited Mrs Edith Madge Childs Care Home 40 Category(ies) of Dementia (40, Mental Disorder, excluding registration, with number learning disability or dementia - over 65 years of of places age (40) Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Service users to include one named person only out of the homes category Date of last inspection 21 April 2005 Brief Description of the Service: Redannick House is one of eighteen homes owned by Cornwall Care Ltd. It is registered to accommodate forty older people in need of personal care, some of whom may be suffering with a degree of dementia and are over retirement age plus one named service user out of category. Admissions are on a planned bases and emergency admissions are avoided whenever possible.Redannick is a purpose built care home situated close to the centre of Truro. It is a nonsmoking home with accommodation provided on one floor that enables all areas to be accessed easily by the service users. A day care facility is provided on the lower ground floor, which has its own entrance and is independently staffed.The grounds of the home are kept tidy with small flowerbeds around the building. There is a patio with seating to the rear. Access to the main entrance of the home is level and suitable for wheelchairs. Car parking space at the front of the home is limited.The building has four wings, each with a sitting room, dining room, kitchenette and bedrooms for ten people. There is also a large communal sitting room close to reception. Meals are prepared in a large kitchen and served in the dining rooms. Assisted bathing facilities are provided and all bedrooms have a washbasin. There are accessible call bells in every room. Suitably qualified care staff provide personal care within a relaxed, friendly atmosphere. There are opportunities for socialising and visitors are actively encouraged. Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspector visited Redannick Residential Home on the 18 August 2005 and spent four and quarter hours at the home. This was an unannounced visit. The purpose of the inspection was to gain an update on the progress of compliance to the requirements that were identified in the last inspection report dated 21 April 2005. In addition the inspector focused on the following key areas of care: health care, complaints, environment, staffing levels and health and safety. On the day of inspection 39 service users were resident in the home. The methods used to undertake the inspection are to meet with a number of residents, staff and the registered manager to gain their views on the services that Redannick offer. Redannick records, policies and procedures were examined and the inspector toured the building. This report summarises the findings of this inspection. What the service does well:
Service users and their representatives stated that Redannick provides good quality care and accommodation. They made various comments about staff such as; they are ‘kind’ and ‘caring’. Residents commented that they felt that they were consulted about their care needs which staff ‘ met at all times’. Residents and staff commented that there are sufficient staffing levels on duty. Residents commented that the welcome to the home was a positive experience and ‘relieved anxiety’ about moving into a care home. Residents commented that they have access to health care and felt that all their health needs were met to a ‘good’ standard. Residents confirmed that there was a varied and stimulating programme of activities that is provided by the home and local community. Residents felt their visitors were welcomed to the home. Residents, relatives and staff stated that if there were any issues they felt able to approach the registered manager directly and that their ideas would be listened to and where appropriate acted on. Staff supervision occurs on a regular bases. Cornwall Care prioritises staff training and is keen to continue to develop staff skills. Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 Page 6 This inspection was positive and the inspector would comment that Cornwall Care Ltd is an organisation that wants to achieve a high standard of care to all its service users and provide appropriate training and support to its staff group. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office.
Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 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 standard(s) EVIDENCE: These standards were inspected at the previous inspection visit on 21 April 2005 and were viewed as met, therefore they were not assessed on this occasion. Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 9 There are suitable systems and policies in place for dealing with resident’s medicines: extra vigilance is required in some areas to further ensure service users safety. EVIDENCE: The medication standard was not assessed at the previous inspection and therefore was inspected during this visit. As all other standards were assessed previously in April 2005 and met the national minimum standards they were not inspected. However it is to be noted that residents continued to confirm that their health needs are met to a good standard and that they felt the staff team were skilled in providing them with good quality care. Cornwall Care Ltd has produced a detailed corporate policy in the ordering, administration, storage and disposal of medication. Designated staff attends annual training in this area of care. In addition the home has a contract with the local pharmacist to ensure that medications are ordered, administered, stored, disposed of correctly, and will provide a audit of their practice. From inspection of the medication, storage was satisfactory. Redannick uses in the main the Monitored Dose System, a tablet count cross-referenced with documentation. Some residents also have prescribed loose tablets; from a
Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 Page 10 tablet count some of these did not tally with documentation. The assistant manager agreed to audit these more carefully. The controlled drugs were all accounted for, stored appropriately and records completed accurately. In the main the medication sheets were completed correctly. When transcribing medication on the MAR sheets these must be evidenced by either the GP or two staff members signature. Medication kept in the fridge was inspected. Daily temperatures of the fridge are monitored. The inspector advised that the insulin pen that is in use is not to be stored in the fridge. This was removed. The returns book has not been signed for the last few months. This needs to be signed by either the receiving pharmacist or two members of staff to confirm that medication has been returned to the pharmacist. Redannick has a recording system so that staff are aware of when certain treatments are to be discontinued. This was satisfactory. The inspector also provided the home with information on medications expiry dates and storage temperatures. Permission from residents is sought in the administration and storage of their medication. No residents self-administer medication at Redannick. Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: These standards were inspected at the previous inspection visit on 21 April 2005 and were viewed as met, therefore they were not assessed on this occasion. However it was observed during this visit resident’s had access to books, TV, music, socialising with other residents and staff and were receiving visitors. Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 Page 12 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 standard(s) 16 The home has a satisfactory complaints procedure that ensures complaints are listened to and acted upon. EVIDENCE: These standards were inspected at the previous inspection visit on 21 April 2005 and were viewed as met; therefore they were not assessed in detail on this occasion. It is to be noted that since the last inspection Redannick and CSCI have not received any complaints. Residents and relatives commented if they had concerns they could raise them with the management team and were confident that they would be listened too and where possible acted upon. Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 Page 13 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 standard(s) 19,20,21,22,24,25,26 Redannick provide a good standard of décor and furnishings creating a comfortable and safe environment for those living there and visiting. Redannick have invested in the homes furnishing and décor to continually improve the facilities in the home. The home is clean. EVIDENCE: The home is well maintained. The home caters for residents with mobility difficulties and all parts within the home are accessible to residents. The home is a secure unit and has access to an open or a secure garden area. The communal areas are comfortable furnished and decorated to a good standard. Residents stated that they enjoyed these areas and it was observed that they could choose which lounge to spend time in, this was the same for the dining areas. All the bathroom facilities were inspected and some had a variety of aids and adaptations e.g. hoists, grab rails. Referrals are made to an occupational
Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 Page 14 therapist when a resident care need has changed and an assessment of ability is needed. The bathroom facilities were decorated to a good standard and all were clean. A sample of resident’s private accommodation was inspected. All the rooms are for single occupancy and were decorated to a good standard. The rooms were personalised and residents commented they were ‘happy’ with their accommodation and facilities. The registered manager stated that a continual redecoration programme of Redannick House is in place. Residents are encouraged to choose the décor of their rooms and bring personalised belongings, including furniture to decorate their rooms. The inspector noted that Redannick House was clean and tidy throughout with no obvious odours. The lower ground floor is used for day care and is where the laundry and kitchen facilities are located. These were not inspected. The inspector observed the following issues to be addressed during a tour of the home: in some residents rooms lighting was at 40 wattage, this needs to be increased to 60 wattage to enable sufficient lighting in rooms. The light in the medication room needs a cover. The inspector recommended that a review of call bells in toilet areas is undertaken as if a resident was unsupervised and fell to the floor they would have great difficulty to be able to reach the call bell to ask for assistance. The registered manager stated that it is unlikely that a resident will be unsupervised in this area so a recommendation to this effect has been made. The carpet opposite room 23 is frayed and needs attention. The registered manager stated these issues would be addressed immediately. Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 Redannick ensure that suitable trained staffs are employed in sufficient numbers at all times. EVIDENCE: These standards were inspected at the previous inspection visit on 21 April 2005 and were viewed as met; therefore they were not assessed on this occasion. Residents continued to make positive comments about staff attitude and skills. During the inspection it was observed that there was sufficient, trained and experienced staff on duty. Staff displayed good communication skills and interacted with residents in a professional yet friendly manner at all times. Staff records were inspected on the previous visit and evidenced the homes robust recruitment process. Staff also commented that they felt the staffing levels were adequate and complimented their access to training and support from the management team. Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36,38 Satisfactory arrangements are in place to provide a safe environment for all who live, visit or work at the home EVIDENCE: The majority of these standards were inspected at the previous inspection visit on 21 April 2005 and were viewed as met; therefore they were not assessed on this occasion. The standards that were inspected on this occasion were in respect of health and safety issues for residents, visitors, staff and management of the home. The records show that policies and procedures have been established to promote safe working practices and provide a healthy and hygienic environment. The services and equipment at the home are regularly maintained and serviced and suitable arrangements are in place about fire precautions and action to take in the event of a fire.
Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 Page 17 Documentation also evidenced that the home undertakes appropriate individual and generic risk assessments, to promote minimising future risks to all who live, visit or work at the home. From discussion with the management team they confirmed, shown by some records that the level of staff supervision is increasing in the home. They aim to achieve a minimum of six supervision sessions a year. The quality assurance process is currently being reviewed and so was not inspected on this occasion. Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x
COMPLAINTS AND PROTECTION 3 3 3 3 x 3 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x 3 x 3 Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 Page 19 no Are there any outstanding requirements from the last inspection? 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 9 Regulation 13 Requirement Medication processes must be audited to ensure that medication sheets are correctly completed, and that the number of tablets tally with medication records A audit of lighting to ensure correct wattage and suitable coverings must be undertaken and appropriate actions completed. Timescale for action 30.12.05 2. 25 23 30.12.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 9 22 19 Good Practice Recommendations The mediation disposal book should be signed by the receieiving pharmacist or by two members of staff. A audit of call bells within toilet locations to ensure that they are within reach of service users should be undertaken and appropriate actions completed. The carpet opposite room 23 should be repaired/ replaced. Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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. Extracts may not be used or reproduced without the express permission of CSCI Redannick House D52-D04 S9124 Redannick House V233122 180805 Stage 4.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
