Inspection on 03/07/06 for Redcote

This inspection was carried out on 3rd July 2006.

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

Redcote 10/07/07

Redcote 14/08/05

Redcote 19/05/05

Redcote 22/11/04

Redcote 10/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Redcote 23 Gainsborough Road Lea Gainsborough Lincs DN21 5HR Lead Inspector Mr Doug Tunmore Key Unannounced Inspection 3rd July 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Redcote DS0000002408.V301427.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Redcote DS0000002408.V301427.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redcote Address 23 Gainsborough Road Lea Gainsborough Lincs DN21 5HR 01427 615700 01427 615700 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Redcote Homes Limited Mrs Jane Green Care Home 28 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (28) of places Redcote DS0000002408.V301427.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. The Home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories: Old age, not falling within any other category (OP) - 28 The 1 bed in category DE(E) is for a service user as named in the Notice of Proposal to Register dated 14 October 2005. The maximum number of service users to be accommodated is 28. One bed in Category DE(E) is for a service user as named in the Preregistration Letter dated 7 December 2005 The maximum number of service users to be accommodated is 28 One bed in Category DE(E) is for a service user as named in the Preregistration letter dated 21 February 2006. 14/08/05 Date of last inspection Brief Description of the Service: Redcote care home is a detached property, which has been adapted and extended to provide accommodation for older people. The home is set back from the main road which runs through the village of Lea and stands in approximately two acres of mature and landscaped gardens, which are accessible to residents. Access to the home is via a blocked paved drive, which extends and includes a ramp to the front entrance. Car parking space is available to the front of the home. Accommodation is provided on two floors. There are twenty-six single rooms and one twin room that is currently used as a single room. Seven of the rooms have en-suite facilities and all have wash hand basins. The proprietor has a house to the rear of the premises in which he stays when visiting the home. The philosophy of the home is to provide a warm, friendly atmosphere in which individuals can have the opportunity to be as independent as possible. The current scale of charges at this home is £385.00, which is a flat rate for all residents. Redcote DS0000002408.V301427.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took into account any previous information held by CSCI including the homes previous inspection reports, their service history, the homes pre-inspection questionnaire and residents questionnaires sent to the home by the Commission prior to this inspection. The site inspection consisted of case tracking a sample of two resident’s records and assessing their care. The inspector spoke with the residents who was being case tracked and joined three other residents for lunch. The inspector also spent time with one senior member of staff and the registered manager. A partial tour of the home and a review of a sample of the records was also included. What the service does well: What has improved since the last inspection? The home has addressed the requirement made at the last inspection. The home has appointed a new manager who has undertaken the fit person interview by The Commission and was found to be qualified and experienced to undertake the task of registered manager. Redcote DS0000002408.V301427.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Redcote DS0000002408.V301427.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Redcote DS0000002408.V301427.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 & 6 The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are admitted into the home only after a full needs assessment has been carried out either by the home and or health care or social care agencies. Written confirmation that the home can meet a prospective residents needs is also undertaken prior to admission. All residents have current contracts. This home does not provide intermediate care. EVIDENCE: A review of all information available prior to this inspection including previous inspection reports dated 19/05/05 and 14/08/05 and evidence seen at this inspection in residents files and care plans showed that the home does not admit residents without a care needs assessment being undertaken. Prospective residents are also written to by the home confirming that they can meet the residents care needs or not. Redcote DS0000002408.V301427.R01.S.doc Version 5.2 Page 9 The Commission sent Resident’s questionnaire forms to the home prior to this inspection and fifteen were returned. Fourteen questionnaires confirmed that residents had information about the home prior to admission and fourteen also agreed that they had received a contract. One resident stated that he had not received a contract. The files of those residents who were being case tracked contained a current contract setting out the terms and condition of their stay. A Local Authority contracting monitoring visit was undertaken on the 04/10/05 and found that ‘the manager or senior carer usually complete a pre-admission assessment and new clients are encouraged to spend a day in the home prior to admission’. Comments received through the questionnaires from residents and relatives were; ‘we made three unannounced visits to Redcote before deciding about the home. Each time we were made welcome and received all the information we required and were shown around the home’. The senior carer stated that she carries out pre-admission care needs assessments prior to admission and residents are encouraged to attend the home for a day to complete the assessment in house. The manager and senior carer confirmed that they have admitted a resident unknowingly outside of the homes current registration. Redcote DS0000002408.V301427.R01.S.doc Version 5.2 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 the following standard(s): 7,8,9,10 The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. The homes policies and procedures provide guidance for the care practices of care staff. Residents or their representatives are involved in the care plans. The home administers medication appropriately to all residents. Care plans do not always address the intimate care needs of residents. EVIDENCE: This inspection found that residents have individual care plans, which evidenced that health care professionals in relation to their health care needs have seen residents. Resident’s files also describe their health and welfare needs. Care plans outlined risk assessments, nutritional and dependency assessments. Care plans also evidenced that they have been reviewed on a monthly basis or sooner depending on changing needs. The reviews and care plans of residents had been signed and dated by the carer and the resident. A Local Authority contracting monitoring visit found that ‘A sample of residents files were examined during the course of the visit, a Standex system is utilised Redcote DS0000002408.V301427.R01.S.doc Version 5.2 Page 11 and provides good comprehensive evidence of effective care planning and record keeping and involves residents and family members as much as possible’. The homes notifiable incidents record was seen and corresponded with the Commissions service history of the home relating to accidents/deaths to residents. Resident’s questionnaires showed that twelve felt that they received the support that they need and three commented that they usually receive the support that they require. The questionnaires also showed that twelve residents felt that staff are always available when they need them and three residents felt that staff are usually available when they need them. A resident stated that ‘he uses a walk in shower and the staff are with me and are very helpful, they wash my back whilst I wash my front, couldn’t wish for anything better than that’. Two care plans were seen and it was found that limited information is available regarding residents likes and dislikes. This area of care planning is centred around food preferences and not those aspects of residents daily living requirements and expectations. Care plans were also seen not to have established the intimate care needs of residents and what help they require when bathing or toileting or how their privacy and dignity can be maintained. A senior care commented that the care plans now need to be reviewed in order to ensure that individual residents views on their privacy is explored and addressed in their care plans. This she said would ensure that the more personal care needs of residents would be addressed. Residents comments made in questionnaires were; ‘staff are very helpful nothing is to much trouble’ (relative), ‘ very happy would have a job to find a better place’ and very settled and happy thank you’. The pharmacist inspected the home on the 08/05/06 and recorded that storage and stock control is carried out appropriately. However, it was also noted that ‘a couple of signatures were missed administration sheets’. Due to this the residents medication sheets were seen and found to be in good order. Residents questionnaires received back from the home showed that fourteen felt that they always get the medical support that they need and one felt that they sometimes did. On the day of the inspection all care staff had gathered in the dining room and were undertaking a medication test as part of learn direct training organised by Grantham College. The homes pre-inspection questionnaire also showed that managing and safe handling of medication training had been undertaken in April 06. Those residents who were being case tracked were found to be able to administer their own medication. One resident stated that he has an inhaler Redcote DS0000002408.V301427.R01.S.doc Version 5.2 Page 12 and has medication at lunch time, which is always on time. He also said that a community nurse visits him weekly. Another resident confirmed that the home has contacted the hospital on her behalf to arrange a consultation for this coming week. Redcote DS0000002408.V301427.R01.S.doc Version 5.2 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 the following standard(s): 12,13,14 &15 The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. Relatives/friends of service users are made welcome in this home. A range of stimulating activities are made available to residents. A choice of meals are available at this home, which are planned monthly in consultation with service users. EVIDENCE: Fourteen residents questionnaires showed that there are activities and they are available to residents always, one resident commented that activities are usually available. A Local Authority contracting monitoring visit found that the ‘home employs an activities coordinator two hours per day on week days, there is an outing organised every other week. Activities are funded by the home’. The minutes of the residents meeting held on the 24/05/06 evidenced that residents are keen on activities and requests were made for visits to a garden centre and a trip to Cleethorpes for fish and chips. Positive comments were recorded about the lunches out and trips to the ice cream parlour. The homes Redcote DS0000002408.V301427.R01.S.doc Version 5.2 Page 14 forthcoming events sheet was seen and showed that; a Easter fayre had been organised, trips out shopping, rides in the countryside and lunches out have been arranged. On the day of the inspection a number of residents were going on an outing the an ice cream parlour. No visitors were seen during this inspection. Residents seen at lunch time confirmed that their relatives visit the home and are made most welcome. They also confirmed that they get involved in those activities that interests them or they have the choice of reading or knitting in the privacy of their rooms. The inspection was undertaken on a hot day and it was noted that drinks were being served and there were drinks in residents’ rooms. Resident’s questionnaires evidenced that twelve always liked the meals and two usually liked their meals. Other written comments received were ‘grub is good’. Three residents who the regulator joined for lunch made complimentary comments about the food that was served in the home saying, ‘the food is good and they have a choice’. The Local Authority contracting monitoring visit found that ‘there is evidence of a well balanced menu offered, residents have a choice and are consulted through the residents meetings to ensure variety and satisfaction’. Redcote DS0000002408.V301427.R01.S.doc Version 5.2 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 the following standard(s): 16,18 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home has in place policies and procedures for addressing and monitoring complaints. Service users feel safe and confident in approaching care staff regarding any concerns that they might have. Staff have undertaken safeguarding vulnerable adults training. EVIDENCE: The home has displayed the service users guide, which contains the homes complaint procedures in the main entrance. The home has a detailed complaints procedure. The homes pre-inspection questionnaire evidenced that no complaints had been made since the last inspection. Residents questionnaires recorded overwhelmingly that they were aware of how to make a complaint and knew who to speak to if they were unhappy. Other comments were ‘ very happy would have a job to find a better place’, quite happy and satisfied, very settled and happy’. Two residents stated ‘that due to past circumstances and memory loss they felt secure in this home and well looked after’. The homes pre-inspection questionnaire showed that safeguarding vulnerable adults training has been undertaken by the majority of care workers. A senior carer confirmed that she had undertaken adult protection training in January 06. Redcote DS0000002408.V301427.R01.S.doc Version 5.2 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 the following standard(s): 19,26 The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well maintained, the standard of the environment and its facilities are appropriate to the needs of residents. The home is clean and free of unpleasant odours. EVIDENCE: The home employs three domestic workers who each work 20 hours per week. No unpleasant odours were detected during this visit. The residents survey was overwhelming in that they confirmed that the home always smells nice and is clean and tidy. One resident said that his room is kept clean and he has clean clothes laid out on his bed. Three residents confirmed that they have personalised their rooms and the home is free of unpleasant odours. Redcote DS0000002408.V301427.R01.S.doc Version 5.2 Page 17 The Local Authority contracting monitoring visit found that ‘ a tour of the home the accommodation appears to be clean and furnished appropriately’. The residents survey was overwhelming in that they confirmed that the home always smells nice and is clean and tidy. Redcote DS0000002408.V301427.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Appropriate recruitment practices are in place. Staffing level meets the needs of residents. The home provides adequate training for care staff. Staff were seen to be competent in carrying out their care tasks. EVIDENCE: A review of all information available prior to this inspection including the homes pre-inspection questionnaire and last inspection carried out in August 2005, showed that; personnel files evidenced that thorough recruitment practices are undertaken to ensure the safety of residents. The registered manger confirmed that no new staff have been recruited in the last year and was able to give a good account of how she would recruit new staff safely, ensuring that they had a satisfactory CRB (Criminal record Bureau Checks). A contract monitoring visit by Lincolnshire County Council found that ‘ the home does not have a high turnover and the majority of staff have been working in the home for more than two years. Files examined had appropriate records are retained, which include application forms, CRB (criminal records bureau checks) written references and a contact of employment. The homes pre-inspection questionnaire and the contract monitoring visits evidenced that ‘the home operates a set training pattern for the year’. Redcote DS0000002408.V301427.R01.S.doc Version 5.2 Page 19 Mandatory training has been identified as being undertaken and certificates seen at this inspection confirmed that professional trainers had undertaken training. The General Social Care Council Codes of Practice, which sets out their responsibilities as care workers looking after vulnerable adults. The homes preinspection questionnaires evidences that 55 of carers have NVQ (National Vocational Qualifications) which means that the home meets the ratio of 50 of care staff trained to level 2. The questionnaire completed by residents showed that twelve felt that they receive the care that they need and staff are available when they needs them. Three felt that they usually receive the care they needs. One resident commented that there was a shortage of staff in the mornings. The residents also said that staff answer the call buzzer quickly. Another resident stated that ‘I ring the buzzer in the day or night carers are here in minutes’. The homes pre-inspection questionnaire and the rota evidenced that there are twenty two care staff and five ancillary workers. The duty rota showed that adequate staff numbers are on duty to meet the needs of residents during the day and night shift. The senior carer was of the opinion that there are enough staff and we spend time with residents. She also confirmed that that she has undertaken mandatory training as well as induction training. Redcote DS0000002408.V301427.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33, 35, & 38 The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. The registered manager is suitably qualified and experienced to carryout her tasks. Records seen show that residents’ health and general welfare and safety are promoted. The home ensures that the residents have the opportunity to voice their views and opinions. Accurate records are kept of residents’ monies. EVIDENCE: The registered manager has worked in this home for seventeen years, as a care assistant, senior carer and became the registered manager in April 05. She has NVQ level 2,3 as well as successfully completing the Registered Managers Award. Redcote DS0000002408.V301427.R01.S.doc Version 5.2 Page 21 The contract monitoring report stated that ‘there is a homely atmosphere in the home and during the visit it was noted that there is a good rapport between the manager, staff, residents and visitors. The home conducts a quality assurance report. The quality assurance report is posted for the information of residents and visitors, as is the last Commission for Social Care Inspection report. However, it was felt that this document needs to be in large print and also modified to ensure easy reading for residents and visitors. The home only deals with personal allowances of residents, which are kept safe. The homes pre-inspection questionnaire states that the proprietor and manager are not responsible for any resident’s affairs, they are handled by residents families. Two residents allowances were checked and an accurate record was kept, with two signatures and receipts available for monies spent. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. The homes pre-inspection questioner evidenced that fire alarm, fire drills and emergency lighting checks have been undertaken. Care staff also receive fire training as part of the homes initial training and as a regular training event. A contract monitoring visit showed that ‘the home operates comprehensive policies and procedures, which are accessible to staff. Redcote DS0000002408.V301427.R01.S.doc Version 5.2 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. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 4 4 x x x x x x 4 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 3 Redcote DS0000002408.V301427.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. Refer to Standard Good Practice Recommendations Redcote DS0000002408.V301427.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Redcote DS0000002408.V301427.R01.S.doc Version 5.2 Page 25 - 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!