Inspection on 17/05/05 for Redbond Lodge

This inspection was carried out on 17th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Redbond Lodge 09/09/09

Redbond Lodge 31/07/07

Redbond Lodge 07/08/06

Redbond Lodge 14/02/06

Redbond Lodge 20/01/05

Redbond Lodge 02/06/04

Redbond Lodge 16/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Redbond Lodge Chequers Lane Dunmow Essex CM6 1EQ Lead Inspector Diana Green Unannounced 17 May 2005 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. Redbond Lodge Version 1.10 Page 3 SERVICE INFORMATION Name of service Redbond Lodge Address Chequers Lane Dunmow Essex CM6 1EQ 01371 873232 01371 874451 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) Runwood Homes Plc Sussan Lesley King Care Home 36 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (36) of places Redbond Lodge Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1 Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 36 persons) 2 Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 18 persons) 3 The total number of service users accommodated in the home must not exceed 36 persons 4 Staffing levels will be monitored for six months from 15 December 2003; they will then be reviewed with the inspector 5 The registered person must not admit persons subject to the Mental Health Act 1983 or the Patients in the Community (Amendment) Act 1995 6 Service users to be accommodated in bedrooms 15 - 37 on the ground floor with the exception of rooms 28, 30 and 33, and in bedrooms 56 - 71 on the first floor Date of last inspection 20 January 2005 Brief Description of the Service: Redbond Lodge provides personal care with accommodation for up to 36 older people. The home is also registered to provide care to older people with dementia.Redbond Lodge is owned by a private organisation named Runwood Homes Plc.The home is located in the village of Dunmow, Essex. Redbond Lodge is a purpose built two-storey care home. The premises have been extended on two floors that are attached to the existing building to accommodate an additional 34 en-suite bedrooms, 4 assisted bathrooms, 2 lounges, 2 quiet lounges, several storage rooms and 2 large seated/walk areas. At the time of inspection the original accommodation was being upgraded and refurbished to provide a total of 74 beds and a dedicated dementia facility. The home has been adapted to meet the needs of service users with limited mobility and is fully accessible through a passenger lift and ramps. Redbond Lodge Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 17/05/05, lasting 6 hours. The inspection process included: discussions with the manager, care team manager, the cook, kitchen assistant, nine staff, ten service users and three relatives; a partial tour of the premises including observations on residents’ bedrooms, bathrooms, the kitchen, medication/clinical room, communal areas and the laundry; and inspection of a sample of policies and records (including any records of notifications or complaints sent to the CSCI since the last inspection). Twenty-two standards were covered, and four requirements and two recommendations made. The inspection found that eighteen of the twentytwo standards inspected had been met, including two that were commended. Action had been taken promptly to address previous requirements and recommendations. The home is undergoing refurbishment and upgrade of the original accommodation and staffing levels and conditions of registrations will be reviewed on registration. It was evident that Redbond Lodge provides a good standard of personal care for residents. The registered manager and staff were welcoming and helpful throughout the inspection. What the service does well: The home provides a welcoming, homely environment and consistently good standards of personal care: residents and their relatives were unanimous in their praise of the manager and staff and said they were very caring and kept them well informed. The relative of one service user said they frequently visited the home and were confidant in the care of their relative as they found all residents to be well cared for and happy when they visited. Another relative said that “staff are excellent. This is a first class home”. Redbond Lodge Version 1.10 Page 6 Residents’ individual health needs are met appropriately and well monitored and prompt referrals are made to GP’s and relevant health professionals where required. Residents are happy and well cared for and this was confirmed from discussion with them and their relatives. One resident said “everyone is nice to me here”. The manager and staff are commended for the development of a bereavement pack that ensure relatives have the relevant and detailed information provided to them, enabling them to feel supported when having to deal with the death of a loved one. Staff are skilled to care for the needs of residents through regular training and supervision by the manager. The management of complaints at Redbond Lodge is commended for ensuring that residents and relatives’ views are listened to and acted upon no matter how minor the issue. What has improved since the last inspection? What they could do better: Increased staffing levels at peak times would enable residents a choice of time in getting up: staffing levels will be reviewed with the inspector on completion of the refurbished and upgraded original premises to accommodate the increased registered beds. Infection control procedures are not always adhered to; the manager could ensure that this features more in the internal audits already in place at the home. Medication training is currently provided in-house but should also be supported by training from a pharmacist/accredited tutor with regular assessment of competencies. Redbond Lodge Version 1.10 Page 7 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. Redbond Lodge Version 1.10 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Redbond Lodge Version 1.10 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 & 5 The service operates a thorough and responsible pre-admission assessment process: care and attention is given to ensuring that the home can meet the individual’s needs, resulting in appropriate admissions. Visits to the home are encouraged prior to admission enabling prospective residents and their relatives to feel confidant about their decision to move in. Individuals’ needs are being well met within the home. EVIDENCE: The manager undertook assessment of prospective residents prior to admission. Evidence of pre-admission assessments was present on all of the three files inspected together with copies of care management assessments to determine if their needs could be met. Information on the person’s needs was detailed and covered all care needs ensuring that care plans developed accurately informed staff on the residents’ needs. The relatives of a resident were spoken with and confirmed that they had been encouraged to visit the home before making a decision and felt that meeting the manager and visiting the home had helped them to be confidant that this was the right home for them, and that they were happy at the home and how their needs were being met. The relative of married couple resident at the Redbond Lodge Version 1.10 Page 10 home said they found the manager approachable and willing to discuss arrangements for their care ensuring their needs were met sensitively and in full agreement with the family. All residents and relatives spoken to were very positive about the care provided at Redbond Lodge and were confident that staff had the skills to deliver the support and care required. Redbond Lodge Version 1.10 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 & 11 There is a clear and consistent care planning system in place that provides staff with comprehensive information and ensures residents’ needs are appropriately met. The health care needs of service users are well met with evidence of good multi-disciplinary working taking place on a regular basis. The systems for administration of medicines are good with clear and comprehensive procedures in place however training for those administering medication is not sufficiently robust. The manager and staff have a good understanding of the needs of terminally ill residents and their relatives that ensures they receive appropriate, timely and sensitive support. EVIDENCE: Redbond Lodge Version 1.10 Page 12 Three care files were inspected. All contained care plans that covered all key needs (physical and social), provided good detail of the action required of staff to meet residents’ needs, and had been regularly reviewed. All contained a comprehensive social care history enabling staff to understand residents’ personal circumstances and to interact with them. Residents and their relatives spoken with said they were aware of the care plan and this was also confirmed by their signatures. Residents spoken to said that staff looked after them well. One resident said they were encouraged to do what they could for themselves but that support was always provided when needed. Staff were observed to treat residents in a friendly but respectful manner, and to assist them in a discrete and dignified way. Two relatives stated that they found all residents were well cared for when they visited and there was happy atmosphere at Redbond Lodge. Assessments for moving and handling/mobility, pressure areas, continence needs and risk assessments for nutritional needs and falls were recorded in the files inspected and had been regularly reviewed. Residents were observed to be well cared for and to have their personal care needs met. The records confirmed that residents had access to chiropody, dental care, physiotherapy, occupational therapists and outpatients ensuring their health needs were monitored and treatment provided as needed. Residents had a full choice of GP and district nurses regularly attended the home ensuring nursing needs were met appropriately with pressure relief equipment provided as necessary. The home had a medication policy for staff guidance and a copy of the Royal Pharmaceutical Society of Great Britain guidance for care homes. Care team managers administered all medication at the home. A former home manager provided medication training and the manager of Redbond Lodge undertook assessment of competencies. There was no accredited training provided by a pharmacist or qualified tutor. However the care team manager administering medication at inspection had received no formal training as yet. Medication was supplied through the local pharmacist and appropriate ordering and disposal procedures were followed. Medication administration records (MAR) were viewed, and were well maintained, although some omissions of signature were evident. The administration of temazepam was well monitored and recorded. From discussion with the manager and staff there was evidence that residents who were dying would receive appropriate care and attention and pain relief. The files inspected detailed the residents’ wishes concerning terminal care and arrangements after death and relatives spoken with said they were confidant in the skills of the staff and manager. The home was well supported by district nurses and advice was accessed as necessary from Macmillan Nurse Specialists enabling residents to receive prompt treatment for pain relief and symptom control. The manager and staff had developed a bereavement pack that provided information on what to expect in the event of a death and advice on how to register a death and organise a funeral. Consultation with relatives had been positive and the home is commended for this initiative. Redbond Lodge Version 1.10 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 & 15 Staffing levels at the home do not always enable residents to have a full choice in their daily life activities. The manager and staff have developed positive relationships with relatives and the local community ensuring residents have the support they need. The meals in this home are good offering both choice and variety and catering for special needs. EVIDENCE: The standard for social contact and activities was not fully inspected. However one resident spoken with said that they got up at 7am “that’s the time they get you up”. Staff spoken to confirmed that they were unable to offer a choice when they were busy. Residents were, however enabled a choice in taking part in activities, attendance at day centres and although encouraged to eat in the dining room, some residents were able to eat in their own rooms. Relatives spoken with said they were welcomed into the home at anytime and staff were friendly and supportive and the manager was always available. The statement of purpose detailed the home’s policies for maintaining contact with friends and relatives. Visitors were observed to meet with residents in private Redbond Lodge Version 1.10 Page 14 and in communal rooms. Involvement in the local community was evident with some residents attending day centres and clubs. The menus and nutritional records confirmed that residents were provided with a choice of three full meals with hot and cold drinks provided at all times and snacks provided in the evening. The menus were changed regularly and fresh vegetables were provided daily. The large dining room had recently been extended and refurbished and provided a pleasant environment for residents. The breakfast and lunch-time meal were observed and were nutritious and well-balanced. Care staff were observed to assist residents in a discreet and sensitive manner. Residents spoken with said they enjoyed the food and there was always plenty to eat and drink. Redbond Lodge Version 1.10 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The systems for dealing with complaints are robust with good evidence that all complaints are taken seriously and acted upon. EVIDENCE: The home had a complaints procedure that was displayed for residents and their representatives’ information. A copy was also contained in the statement of purpose/service user guide and provided details of how to contact the Commission, local health authority and social services. The registered manager recorded all complaints, including verbal complaints. The record examined provided evidence that all complaints were taken seriously and appropriate action was taken promptly to resolve any issues raised. This is acknowledged to be best practice in the complaints handling/ management. Redbond Lodge Version 1.10 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) 19, 25 & 26 The recent extension to the home has raised the standard of the environment providing residents with an attractive place to live that is safe and comfortable. The environmental standards for infection control have improved but some attention to safe care practice is required. EVIDENCE: The Home was well furnished, well maintained and met the needs of service users. A new purpose built extension had been built since the last inspection and comprised all single en-suite rooms and communal rooms refurbished to a high standard. A programme of planned maintenance was in place and accurate records were kept. There were plans to develop two secure quadrangle gardens to sensory gardens on completion of upgrade and refurbishment of the original building. Records inspected confirmed that the building complied with the requirements of the local fire service and environmental health departments. Redbond Lodge Version 1.10 Page 17 From observation and inspection of records there was evidence that the heating, lighting, water supply and ventilation of the home met the relevant environmental health and safety requirements and the individual needs of residents. Checks to prevent risks from Legionella were confirmed from the records. The premises were clean, hygienic and free from offensive odours throughout. Hand-washing facilities were in provided in all clinical areas as required. Two sluice disinfectors were provided, one on each floor of the new extension. The home had appropriate policies and procedures for safe practice to prevent the risk of infection and care staff had received some training. However the laundry assistant had not received training in infection control and neither care staff nor the laundry assistant were adhering to decontamination procedures that place them at risk of infection. Redbond Lodge Version 1.10 Page 18 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, 29 & 30 Staffing levels are insufficient at peak times to enable residents a choice in daily activities. The recruitment processes are thorough ensuring the protection of service users. Training is provided in a planned systematic way ensuring staff have the appropriate skills to care safely for residents. EVIDENCE: The registered manager was not in attendance at the home until late morning. The care staffing levels comprised five care assistants and one care team manager for 34 residents. There were six residents who required moving with the assistance of a hoist, requiring two care assistants and one who required assistance with eating. One resident spoken with (Standard 12) said they were not enabled a choice of time in getting up. Care staff spoken with confirmed that were unable to offer residents a choice when they were busy. The home maintained a staff rota confirming the number of staff on duty and the capacity in which they work. The staff records confirmed that no one under the age of eighteen was employed to provide personal care. The home was staffed with domestic assistants in sufficient numbers to ensure the cleanliness of the home. The files of four new staff members were inspected: these contained evidence that all the required checks had been obtained (two satisfactory references, CRB/POVA checks) and copies of birth certificates, passports, photographs obtained before the individuals commenced employment at the home. However there was no work permits available for three staff employed from overseas. Redbond Lodge Version 1.10 Page 19 All had received a statement of terms and conditions of employment. Staff spoken with confirmed they were provided with a copy of the General Social Care Council Code of Conduct. Individual training records and evidence of induction training were inspected for the four new care staff and two existing staff. The records confirmed that a four week induction training to NTO specification had been provided and all mandatory training including health and safety, fire safety, basic first aid and moving and handling had been provided as required. Redbond Lodge Version 1.10 Page 20 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, 37 & 38 The home is well managed and run in the best interest of residents. The manager promotes an open, positive and supportive atmosphere that enables staff to feel confident and competent in their practice. Records required to protect residents were generally well maintained, up to date and stored safely. The health, safety and welfare of residents and staff is promoted through the policies and practices of the home. EVIDENCE: The registered manager, had managed the home for several years and was currently undertaking NVQ level 4 training. Recent updated training was evident including dementia care training that was appropriate to the needs of residents. From discussion with staff there was evidence of regular handover meetings held between shifts. Residents and relatives spoke highly of the manager of the home said they found her approachable and were confidant in her skills. Redbond Lodge Version 1.10 Page 21 Records required by regulation for the protection of residents viewed on this occasion included a sample of: staff rotas; staff recruitment records; residents’ care plans; daily records (including weight monitoring); medication records; menus; records of complaints and accident records. Where relevant, records have been commented on under he relevant standard, but all were generally well maintained and up to date. The home was safe, well managed and had the relevant health and safety practices in place. There was evidence from observation, inspection of the records and in discussion with staff and residents, that the manager ensured the health and safety of staff and residents as far as reasonably practicable. Redbond Lodge Version 1.10 Page 22 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 x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x 3 2 STAFFING Standard No Score 27 2 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 4 x x 3 3 x x x x 3 3 Redbond Lodge Version 1.10 Page 23 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(2) &13(6) Requirement The registered person must ensure that no care staff administers medication before they receive appropriate training and are assessed as competent. The registered person must ensure that infection control practices do not include sluicing of foul linen The registered person must ensure that the laundry assistant receives infection control training The registered person must ensure that staffing levels are adequate to enable residents a choice of time in getting up Timescale for action Immediate informed at inspection Immediate informed at inspection 30/06/05 Immediate informed at inspection 2. 26 13(3) 3. 4. 26 27 13(3), 18(1)(c) 18(1) 5. 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 29 38 Good Practice Recommendations The registered person should ensure copies of work permits where relevant are available at inspection The registered person should ensure that staff accident records are used in accordance with the Data Protection Version 1.10 Page 24 Redbond Lodge Act 1998 Redbond Lodge Version 1.10 Page 25 Commission for Social Care Inspection Fairfax House Causton Road Colchester Essex COr 1RJ 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 Redbond Lodge Version 1.10 Page 26 - 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!