Inspection on 19/09/05 for Redbank House Care Home

This inspection was carried out on 19th September 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Redbank House Care Home 25/07/06

Redbank House Care Home 09/05/05

Redbank House Care Home 24/01/05

Redbank House Care Home 23/06/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Redbank House Care Home Town Street South Leverton Nottingham DN22 0BT Lead Inspector Jayne Hilton Unannounced 19 September 2005 at 10:00 am th 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Redbank House Care Home Address Town Street South Leverton Nottingham Nottinghamshire DN22 0BT 01427 880716 01427 884430 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) Voyage Limited Acting manager Christine Hamblyn Care Home 7 (Seven) Category(ies) of Learning Disability (LD) - 7 (Seven) registration, with number of places Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 9/05/05 Brief Description of the Service: Redbank House is a large family home in a quiet village. The garage, has been converted into a second self-contained flat in order to provide independent living for a service user. A seperate bedroom is also accomodated in the garage building. A conservatory houses the pool table and is used as a games room.The drive provides ample parking for staff and visitors. The home provides transport enabling service users to access other towns and cities.Staff have contacts within the colleges around the Nottingham area and all service users are currently enrolled on various courses. Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on 19th September 2005 between 10.15am and 1.15pm. The Inspector was Jayne Hilton. Six service users contributed to the inspection. A partial tour was included in the inspection, which, mainly focused on the requirements and recommendations set at the previous inspection and the standards not assessed at the last visit. Two care plans were examined and associated documentation. Records inspected were complaints, rotas, water temperatures, maintenance records, staff personal files and medication administration records. The outcomes for service users, is assessed as good. What the service does well: Service users are supported to make choices within their lifestyles, despite having complex needs and requiring structured programmes in order to meet these. The service users residing at Redbank House report that they are happy with the service provided. Service users praised the home highly, saying it is a wonderful place to live and scored it 10/10. The success of the work and philosophy is demonstrated within the service users development plans and by the comments made by service users. Staff have been innovative and creative in providing opportunities, which promote community integration. The home is clean, comfortable and homely. The Service users with Prada Willis syndrome are supported very well and they have clearly achieved many goals. Service users benefit from a well run home that generally promotes and protects their health and safety. Quality monitoring is integral to the homes management systems. Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 6 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 Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 7 contacting your local CSCI office. Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2, Service users are given clear information about the service, its specialised nature, and regarding any structured daily routines, which the service users are consulted about and sign that they agree to. EVIDENCE: The statement of purpose was examined and the standard assessed as met. New versions are currently being printed for Voyage and with the newly employed managers name included. A welcome pack that is given to new service users was kept in the service users personal file. Needs assessments were in place in the two personal files examined and development plans had been devised from the individual assessed needs. Any restrictions on choice, freedom, services or facilities are documented and service users were very aware of these Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7, 8,9 Service users are supported with decision making and in their daily lives through structured and appropriate development plans. The system for review evaluation and monitoring has been improved has the documentation for the assessment of daily living skills, and the present system does demonstrate the great achievements made regarding service users goals and aspirations. EVIDENCE: The four service users spoken with explained their lifestyles to the inspector and how their Prada Willis Syndrome affects this. Their daily lives were filled with structured programmes, which were varied in meaningful activity, leisure, and responsibilities. Although there needs to be structure within the lives of the service users who live at Redbank House, the staff team offer choice options within the structure. The development plans examined were detailed and appropriate however, these are being revamped to include person centred planning. Staff, are currently undertaking training in this area and one service user’s file demonstrated evidence that these had been reviewed on a monthly basis. Consent forms were signed where limitations were placed, such as for locking away food, however service users confirmed that they are given a Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 11 choice about food. Service users spoken with were aware of the development plans and had contributed comments within them. Each service user has a responsibility in the home, which is recorded in their development plan. Service users informed the inspector of their responsibilities, for vacuuming the house and washing the pots etc. A House meeting is held regularly, a service user told the inspector that they talk about concerns and activities and all service users get a copy of the minutes and each service user takes turns to chair the meeting. The acting manager explained that key workers and co-key workers are allocated, according to their skills and experience and service users agreed this does cause conflict between some service users. An issue regarding a service user running the bath independently is reported to be resolved. Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14,15, 16 11, 12, 13, Service users are well integrated within their local and wider communities and are provided with varied opportunities and responsibilities within their daily lifestyles and individual preferences. The manager and staff team have been innovative and instrumental in enabling service users to gain meaningful activities and employment and have promoted an ethos of valued participation both within and outside the home environment and are commended for this. The management of the complex needs of service users is balanced with good promotion of individual rights. EVIDENCE: Service users are able to receive visitors at any reasonable time and some have personal relationships/friendships both at the home and outside of the home. The Inspector is satisfied that appropriate support and input is given regarding this and that information is fully documented in care plans. Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 13 Documentation in the development plans and conversations with service users alongside observations made provided much evidence that service users have opportunities to maintain and develop social emotional, communication and independent living skills. Development plans were full of certificate of achievement at local colleges, birds of prey group etc. The dog walking service for local people in the village is carried out by a number of service users who live at Redbank house and this has enabled service users to integrate into community life and maintain a neighbourly relationship with the community. It also provides earnings for the service users, responsibility and provides healthy exercise. One service user also has a paper round with staff support. Service users spoken with talked about going out to the local pub and community activities, including church and car boot sales. Many of the service users require 1: 1 support to achieve these tasks and which is provided, however recent shifts had been understaffed and this had restricted service users opportunities. Service users rooms were full of personal items including videos, games, and music. Service users confirmed they have been on various outings and a holiday to Bridlington, however one group holiday was a bit of a disaster according to one service user as there was confusion over the sleeping facilities. Activities are planned within House meetings. The conservatory provided a wide range of facilities and recreational equipment. The service users preferred term of address is documented on the service users personal information. The manager reported that staff had been reminded regarding the inappropriate practice of using nick- names for service users. Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 Service users are provided with flexible personal support to maximise privacy, dignity, independence and control over their lives. There are satisfactory systems in place and being developed for ensuring the healthcare needs of service users are met, however there are minor areas to address There are examples of good practice within the area of medication. EVIDENCE: Service users informed the inspector that they choose their own clothes when getting up in a morning and confirmed staff support for personal care as identified within the personal development plan. Service users were observed, to be dressed in varying styles, which reflected their personality. The bedrooms inspected were also personalised. Support from specialist professionals is documented in the development plan. Where service users present challenging behaviour this is covered within development plans and charts. A key worker file has been developed and contains monthly reports of aspects of the service users life, including health appointments and behaviour analysis. Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 15 There was evidence of other health care checks such as chiropody, foot care, optician, dentist, routine smear tests, and GP visits, however although the manager reported that annual well persons checks had taken place, this had not been documented There was good information about the prescribed medication of individuals on the two development plans examined and this section is being improved by developing it into a medication profile for each individual, detailing medication reviews and any changes in medication and reasons why. Signatures of staff who administer the medication were evident and placed in the front of the chart folder. Prescriptions are processed and dispensed by the local surgery. The manager reported that the service provided by the local surgery was very good. Staff who administer medication undertake medicines management training by distance learning, linked with the local college, although no competency assessments are undertaken currently, new paperwork has been developed and this should be implemented promptly. Medication is stored in a lockable cabinet in a locked store cupboard and keys are handed over each by Team Leaders or by the manager. A random check on the controlled drugs demonstrated a correct balance in recording and countdown of controlled drugs. There are policies in place for medicine management, including for drug errors. A copy of the drug error policy is placed where staff can easily access the information and it prompts staff to report drug errors under regulation 37. The manager reported that there have been no drug errors since the previous inspection. Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Service users have a good knowledge of dealing with concerns and complaints EVIDENCE: Service user’s explained to the inspector that they know how to make a complaint should they have one. There are three recorded complaints since the last inspection. CSCI had received one in July 2005 about low staffing levels and which was investigated by the manager of the home and not upheld. Two complaints had been made directly to the home, one about on road parking, and the other about an incident in Retford, and the way staff spoke to a service user. Both have been resolved satisfactorily. A copy of the complaints procedure had been issued to those service users whose personal files were examined. The policy states that all complaints will be responded to within 5 days. Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27,28, 30 Service users live in a homely, clean, comfortable and safe environment. Personal and communal space meets the needs of individuals residing in the home. EVIDENCE: A part tour of the building was undertaken at the inspection. Furnishings and fittings were in good order and were domestic and homely. One bedroom examined had en-suite facilities with a bath. A service user’s, self- contained flat, sited within the garage conversion was also inspected. All were personalised, spacious and appeared to meet the needs of the individual lifestyles. All bedrooms examined were furnished and equipped appropriately and service users had added extra items as required such as storage trolleys and chests. The wardrobe and drawer facilities provided were very good. All doors were lockable and lockable facilities are provided. Toilet and bathroom facilities were sufficient. One central bathroom has sauna and Jacuzzi facilities, which are not in working order. The manager reported that she wants to re-instate the sauna as a service user has requested this, Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 18 however there are risk issues and the service users GP is to be involved. This is still outstanding from the previous inspection. A bidet has been removed from the main bathroom and the manager reported that new floor-covering is in order. A bath panel is missing from the bath on the round floor and needs repair/replacing. One service users room needs the ceiling redecorating due to water damage from a leak in the roof. The manager has requested this. The work has been held up by the event of another leak. The ceiling has been re-plastered. Service users spoken with were obviously proud of their home, explaining that they like their home to be clean. The home was clean throughout. The utility room is cited adjacent to the garage conversion and has a washing machine, which meets sluicing and disinfecting standards and a dryer. There is a large garden and enclosed courtyard with pond. An area, which has become overgrown, is not used by service users, however the manager reported she has plans to develop this area into a sensory garden. Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 Service users needs and opportunities are not being fully provided for when staffing levels fall below 5.5 staff. Recruitment practices are generally good, however not all staff files were completed as required by regulation. EVIDENCE: The rota was examined and this identified that five support staff should be rosta’d on most daytime shifts but sometimes this is increased to six. The rota is devised to meet the 1:1 staffing needs of service users. When trips or events are arranged staffing be increased as required. 1 staff sleeps in and 1 staff is awake for night- time arrangements. The manager works supernumery most of the time. The examination of the rota demonstrated that there has been a fall in staffing numbers provided on some shifts, some even falling to two staff on rare occasions, which is not acceptable practice. Several shifts were covered by, 3 staff with the manager working care hours if needed. The staffing levels must be maintained to 5.5 as three service users are funded for 1:1 support. Bank staff are employed to cover sickness and holidays, however the home has lost four staff recently to another service close by. The manager must send copies of the staffing rota on a weekly basis to CSCI. Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 20 Three staff personal files were examined and all contained satisfactory checks, however all three did not contain a photograph of the staff members and one was missing a copy of a birth certificate. Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,42 Service users benefit from a well run home that generally promotes and protects their health and safety. Quality monitoring is integral to the homes management systems. There are identified issues around surface temperatures of radiators and water temperatures, which must be addressed to ensure the safety of service users. EVIDENCE: The acting manager is a long serving staff member, who was offered the post formally after the last inspection. An application has been submitted to CSCI for assessment for the fit person process. The acting manager is currently undertaking NVQ 4. Service users stated that the manager is the best manager ever. Evidence was seen of quality monitoring systems in place for example service user surveys, The Quality Tree file and regulation 26 visits. Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 22 A plumber has recently attended the home to address the regulation of water temperatures. Records showed that on occasions the temperatures of water is above 43 degrees and although a comment sheet has been added as to what action has been taken to remedy the situation this had not been completed, neither was there any record of a retest. Water outlet temperatures must be regulated to 43 degrees. The manager reported that the problem with water pressures is now resolved. There was evidence in place for the prevention of legionella. Radiator covers are not yet provided however risk assessments have identified, the risk of surface temperatures in the home and these have been ordered for some areas, others are to have shelves fitted or fabric covers. Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 4 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x x 1 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Redbank House Care Home Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x 3 x x 2 x C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 24 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 YA33 Regulation 19 Requirement Ensure staffing levels are maintained at 5.5 provision and copies of the weekly rotas actually worked must be sent to CSCI unitil further notice as evidence of this Ensure that all staff files contain the required documentation as specified in schedule 2 Ensure water temperatures are regulated to 43 degrees Timescale for action 26th September 2005 2. 3. YA34 YA42 7, 9, 19 12, 13, 16, 23 19th October 2005 19th October 2005 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. 4. 5. Refer to Standard YA 19 YA20 YA25 YA26 YA 42 Good Practice Recommendations Ensure annual well person checks are fully documented in service users files. Implement the staff competency assessment promptly. Replace/repair the damaged bath panel. Re-decorate the ceiling in the specified service users bedroom. Chase the work order for the radiator covers. Redbank House Care Home C03 C53 S8737 Redbank House V246062 190905 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Edgeley House Tottle Road Riverside Business Park Nottingham, NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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