Inspection on 21/04/05 for Redannick House

This inspection was carried out on 21st April 2005.

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

Redannick House 24/01/07

Redannick House 18/08/05

Redannick House 26/10/04

Redannick House 26/04/04

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

CARE HOMES FOR OLDER PEOPLE Redannick House Redannick Lane Truro Cornwall TR1 2JP Lead Inspector Lynda Kirtland Announced 21 April 2005 09.30 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 Rednannick House V212317 210405 Stage 4.doc Version 1.20 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 Rednannick House V212317 210405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Service users to include one named person only out of the homes category Date of last inspection 26 October 2004 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 Rednannick House V212317 210405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector visited Redannick on the 21 April 2005 and spent the day at the home. This was an announced visit. On the day of inspection 34 service users were resident at Redannick. The inspector met with 18 service users and 3 representatives, a number of staff and the registered manager to gain their views on the service that Redannick provide. In addition the inspector examined records, policies and procedures and toured the building. This report summarises the findings of this inspection. What the service does well: What has improved since the last inspection? Redannick have a competent management and staff team, which have allowed the day-to-day operations of the home to be run in a consistent manner. All service users felt that they knew staff well and that they could approach staff with issues about their care if they arose. Redannick House D52-D04 S9124 Rednannick House V212317 210405 Stage 4.doc Version 1.20 Page 6 Redannick has piloted the ‘food project’. The aim of this project is to provide high quality nutritious food in an attractive manner and to encourage service users to maintain their self-caring skills. From discussion with service users, their representatives, staff and from the inspectors observations this was viewed to be a positive social experience for service users. The last inspection identified two requirements and one recommendation in respect of minor alterations to environmental factors. These have been complied with. Cornwall Care Ltd is continuously looking at how to develop the service they provide further. Future training in the areas of care planning and adult protection are in process. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Redannick House D52-D04 S9124 Rednannick House V212317 210405 Stage 4.doc Version 1.20 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 Rednannick House V212317 210405 Stage 4.doc Version 1.20 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) 1,2,3,4,5, Redannick has comprehensive information, which in forms service users and their representatives about the services that Redannick provides. Prior to admission, service users and their representatives participate in a pre admission assessment with members from the management team to identify individual care needs. A trail period of stay within the home is offered. Emergency admissions are avoided wherever possible EVIDENCE: Redannick House D52-D04 S9124 Rednannick House V212317 210405 Stage 4.doc Version 1.20 Page 9 Cornwall Care ltd has produced a corporate Statement of Purpose and Service users guide that has been individualised to reflect the services that Redannick House provides. These documents are available on audiocassette if requested by service users. From discussion with service users and their representatives, plus inspection of three service users files it was evident that they are consulted in Redannick pre admission assessment. Care needs identified by the referring professional assessments were incorporated in the assessment process and transferred to care plans This assessment is detailed and identifies the service users individual physical, emotional, social, educational and leisure needs and how the home would aim to address them. A months trail period is offered to all new service users after which a review is held with all parties present to consider if the placement is appropriate and if so a long-term placement will be provided. Service users and their representatives commented that the preadmission and ‘moving in period’ are carried out sensitively by staff and could not see how this process could be improved. They also stated that this was undertaken with their participation and that their care needs were identified accurately Financial expectations and accountability are clearly stated in the service users contract with the home, which has been signed, by the service users or their representatives and the home, or referring local authority. Throughout the inspection the inspector observed staff that displayed great skill in communicating and providing personal and emotional care to service users. Staff training is a priority to Cornwall Care Ltd and the staff commented that the training they receive assist them in their daily work. Redannick House D52-D04 S9124 Rednannick House V212317 210405 Stage 4.doc Version 1.20 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 standard(s) 7,8,10,11 Service users and their representatives are consulted in the implementation and subsequent reviews of their individual care plans. Care plans ensure that physical, emotional, social, educational and leisure pursuits are assessed and action to address the care needs are detailed for all staff to meet in a consistent manner. Service users are treated with dignity and privacy at all times. EVIDENCE: Redannick House D52-D04 S9124 Rednannick House V212317 210405 Stage 4.doc Version 1.20 Page 11 From discussion with service users, their representatives, staff and inspection of documentation it was evident that individual care needs are identified appropriately. From inspection of service users files, and in discussions it is evident that Redannick encourage service users and their representatives to express their views in the formation of their care plans. The care plans are detailed documents, which clearly identify service users skills and where assistance is needed. From this the care plan specifies what actions staff should take to ensure that the care need is approached in a consistent manner. Staff confirmed that they are more involved in the care planning and reviewing stages of the individuals care plan. The registered manager stated that corporate training is occurring in the development of care planning process, which will be cascaded to all staff. Service users and their representatives commented that health needs are met by the staff at the home and by external professionals to a high standard. Detailed records of all health professional visits to individual service users further evidenced this. All service users spoken with stated that staffs display a high standard of respect in their daily interactions. Service users stated that staffs ensure that their privacy and dignity is maintained and could not see how this area of care could be improved. In addition the inspector observed staff communicating with service users in a professional manner at all times, alongside a sense of humour when appropriate. Cornwall Care Ltd has relevant policies on this area of care, which are incorporated, in staff’s induction process as well as through NVQ training. Cornwall Care Ltd has implemented a comprehensive policy addressing palliative care. The registered manager stated that service users views and wishes in respect of their health deteriorating, or in the event of their death are gained and included on the individuals care plan. Family are encouraged to be as involved as they wish with their relatives care and the registered manager will attempt to accommodate relatives overnight at the home if this is needed. Redannick House D52-D04 S9124 Rednannick House V212317 210405 Stage 4.doc Version 1.20 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 standard(s) 12,13,14,15 Service users social, educational and leisure needs are identified and Redannick aim to provide a variety of activities in the home. Service users visitors are encouraged to visit their relative. Service users are encouraged to retain links with the local community. Cornwall Care limited has reviewed the provisions of meals in all the homes, to ensure a high standard of dietary provisions are maintained. EVIDENCE: Redannick House D52-D04 S9124 Rednannick House V212317 210405 Stage 4.doc Version 1.20 Page 13 From discussions with service users they commented that there is ‘enough to do’ during the day at Redannick. Service users recalled a variety of activities that are provided: i.e. drama therapy, trips out, celebrations, hand massage, games, keep fit and church services. The inspector observed a variety of activities occurring during the inspection and saw information on display advertising future events. Redannick policies and documentation demonstrate that they aim to encourage service users to pursue their hobbies and interests. Individual interests are recorded in service user care plans and their ‘life story book’. Service users views are sought in the quality assurance process. Service users have opportunities to access advocates and some choose to have relatives act on their behalf. Relatives and service users stated that the home is welcoming to them. Service users made positive comments to the inspector in the variety and quality of food provided. It was evident from discussions with service users and their representatives and staff that there is a choice of main meal and that alternative meals will be provided. Kitchen staffs were aware of individual dietary needs. From the inspectors discussion with kitchen staff and documentation seen it was evident that the kitchen staff have a sound knowledge of dietary needs, catering and appropriate qualifications. The dining areas were furnished to a good standard. Cornwall Care ltd has provided training to all homes managers and chefs in the ‘Food Project’. This has focused on the nutritional and social aspects of food. It’s aim is to provide a service users focused meal provision encouraging meal times to be social occasions whilst allowing service users the opportunity to maintain their own independence and skills i.e. encouraging self serving of food, menu cards to be introduced and to improve the presentation of meals. The home has purchased new furniture i.e. serving dishes and trolley, to implement this project. From the inspectors observations it was noted that some service users were assisted with their meals whilst others were encouraged to serve themselves. From discussions with service users they were satisfied with how the meals are served and did not raise any issues. From discussion with catering staff they were positive in the changes made to menu provisions, and presentation. The chef stated that the ‘food project’ would be reviewed in three months. From inspection of the kitchen areas and from the recent Environmental Health Inspection no issues were identified. Redannick House D52-D04 S9124 Rednannick House V212317 210405 Stage 4.doc Version 1.20 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 standard(s) 16,17,18 Cornwall care Ltd has a corporate complaints and whistle blowing policy. The complaint policy is on display and the management team encourage service users and their representatives and staff to voice any concerns so that they can be addressed. The registered manager ensures that service users are protected from all forms of abuse with staff having knowledge through training of Adult Protection issues, which helps to protect service users. EVIDENCE: Cornwall Care Ltd has completed policies in respect of the complaints procedures. Redannick and CSCI have not received any complaints about the home. From the inspectors discussions with staff and service users and their representatives all stated that they had ‘no grumbles or worries’ and that if they had they felt able to approach the management team for these to be addressed. From discussion with some service users they confirmed that they had a postal vote to use in the forthcoming general Election. They also confirmed that there is access to local advocacy groups, solicitors or that family members will act on their behalf. Cornwall Care Ltd has a corporate Adult Protection policy. It would be beneficial if the policy could be expanded so that staffs are aware of how and within what timescales they would need to initiate the policy. The company does provide training in the area of abuse, both at induction and also via the NVQ training. The registered manager stated that the management team Redannick House D52-D04 S9124 Rednannick House V212317 210405 Stage 4.doc Version 1.20 Page 15 would be attending a course in respect of adult protection and POVA guidance and processes. In addition the registered manager has access to the DOH guidance’ No Secrets’ and the Local Authorities Adult Protection Procedures. These were observed to be in the managers’ office. The home has a restraint policy but this was not inspected on this occasion. Redannick House D52-D04 S9124 Rednannick House V212317 210405 Stage 4.doc Version 1.20 Page 16 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) 24,25 Redannick provide a good standard of décor and furnishings creating a comfortable and safe environment for those living there and visiting. EVIDENCE: Only the previous requirements and recommendation in respect of the environmental standards were inspected on this visit. It was noted that compliance has been achieved. Redannick House D52-D04 S9124 Rednannick House V212317 210405 Stage 4.doc Version 1.20 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 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) 27,28,29,30 Redannick ensure that suitable trained staffs are employed in sufficient numbers at all times. EVIDENCE: On the day of inspection four care staff, float, plus domestics, handyperson, kitchen staffs, laundress, administrator and managers were on duty. Staffing ratio during waking hours is aimed to be 1:8. At night there are three waking night staff plus a manager on call. The registered manager stated that the home has needed to employ agency workers, in the last weight weeks for 33 shifts. The registered manager stated that there would be a vacancy for one care post and activity coordinator. Service users and their representatives were all complimentary about the care and approach they receive from the staff team. From discussion with staff they all commented that they felt that there is sufficient staff on duty and that they ‘work as a team’. The inspector observed staffs that were competent in their work. Seventy five percent of staff has achieved a minimum of NVQ level 2 or above. Some staff has completed first aid training. Cornwall Care Ltd prioritises staff training and from discussion with staff and inspection of staff files this demonstrated a commitment to staff updating their training. From inspection of recently recruited staff files they evidenced that appropriate employment checks have been completed. Cornwall Care Ltd has detailed recruitment policies. Redannick House D52-D04 S9124 Rednannick House V212317 210405 Stage 4.doc Version 1.20 Page 18 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) 31,32,34,35,36,37 The registered manager is competent in her role. She ensures that the management approach creates an open, positive and inclusive atmosphere. Financial accounts are maintained. EVIDENCE: Redannick House D52-D04 S9124 Rednannick House V212317 210405 Stage 4.doc Version 1.20 Page 19 The registered manager has undertaken relevant training to update her knowledge in the area of older persons care. The staff team and service users spoke positively regarding the accessibility of the management team to voice any ideas as to how to improve/change the service and that likewise they could express any concerns to the management team. Staff also stated that they meet with the management team approximately 3 monthly, minutes were inspected. Staff felt that these meetings were beneficial and also commented that they felt consulted in the future developments of the home. The registered manager stated that Cornwall Care Ltd have completed an employee survey which focused on job satisfaction and support. The registered manager has received verbal feedback form her group manager that the survey was complimentary about the support and management style that she adopts. Cornwall care Ltd is a not for profit charity and accounts are maintained at Cornwall care Headquarters. The registered manager stated that the home is financially viable and has relevant insurance in place. Cornwall care Ltd have cooperate policies in the management of service users monies. Service users are encouraged to manage their own monies and hold their own accounts. However they can sign an agreement to request that Cornwall care assist them in the management of a small amount of their monies. From inspection of service users monies records were accurate and tallied. From inspection of staff files, and discussion with staff they confirmed that they had been a positive induction to the home. In respect of supervision this was seen to occur but as the registered manager states this needs to improve to ensure that staff receives at least six supervision sessions per year. A recommendation to this effect has been identified. Records held by the home are stored in a confidential manner and in line with the Data protection Act. Redannick House D52-D04 S9124 Rednannick House V212317 210405 Stage 4.doc Version 1.20 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION x x x x x 3 3 x 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 Standard No 16 17 18 Score 3 3 3 3 3 x 3 3 2 3 x Redannick House D52-D04 S9124 Rednannick House V212317 210405 Stage 4.doc Version 1.20 Page 21 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 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. 2. Refer to Standard OP1 OP36 Good Practice Recommendations the adult protection policy should be expanded to include a timetable of initating a adult protection referral and explain what processe should be followed. staff should have a minimum of six supervioin sessions a year. Redannick House D52-D04 S9124 Rednannick House V212317 210405 Stage 4.doc Version 1.20 Page 22 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 Rednannick House V212317 210405 Stage 4.doc Version 1.20 Page 23 - 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. 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