Inspection on 24/04/08 for Redcotts

This inspection was carried out on 24th April 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Redcotts 24/02/10

Redcotts 21/01/10

Redcotts 19/11/09

Redcotts 26/02/09

Redcotts 09/09/08

Redcotts 02/05/07

Redcotts 16/05/06

Redcotts 24/11/05

Redcotts 07/04/05

Redcotts 03/11/04

Redcotts 14/07/04

Redcotts 14/01/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Redcotts 96 Wensleydale Road Hampton Middlesex TW12 2LY Lead Inspector Sandy Patrick Key Unannounced Inspection 10:30 24th April 2008 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 Redcotts DS0000017388.V361450.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. Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redcotts Address 96 Wensleydale Road Hampton Middlesex TW12 2LY 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) 020 8979 5477 020 8979 5491 redcottshome@aol.com Mr Sajjad Hassan Stella Vuyiswa Brenda Lehola Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th December 2007 Brief Description of the Service: Redcotts is a privately owned residential care home registered for up to 18 older people. The owner visits the home on a regular basis and a manager is employed to oversee the day-to-day operation of the home. The home is situated in a residential road in Hampton, close to local shops, community facilities and public transport networks. Communal rooms include a lounge and separate dining room. The home has a large rear garden. Residents’ rooms are on the ground and first floor of the home. The home is staffed 24 hours a day. Information about the home is available in a Service User Guide, which includes information on the aims and objectives of the service. The home’s charges range from £499 to £520 per week. Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. During this inspection a Regulation Inspector visited the home on 24th April 2008. This visit was unannounced. We met with the people who live and work at the home, some visitors and the Owner. The Manager was not at work at the time of the visit. We looked at the environment, records the staff use and the care given at the home. We also wrote to the people living at the home, their relatives, other visitors and the staff and asked them to complete questionnaires about their experiences. We asked the Manager and Owner to complete a quality self assessment. They were not able to complete this in time for this inspection. Two people who live at the home, four of their relatives, another visitor and two members of staff returned questionnaires to us. People said that they were generally happy with the care they received, although there were not always things for them to do. One person said that the staff were ‘very kind and helpful’. One person said ‘there does not seem to be many staff around during the day’. Another person said, ‘they look after my mother with great care.’ Another person said, ‘the staff are helpful and friendly but do not have enough talk time for the residents’. Nine people were living at the home when we visited. What the service does well: What has improved since the last inspection? There has been some staff training. Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 6 The recording of accidents and health care has improved and shows that people are getting the medical care they need. There have been some improvements to the building. The standard of cleanliness has improved. The Manager has been registered with the Commission for Social Care Inspection. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Redcotts DS0000017388.V361450.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 Redcotts DS0000017388.V361450.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People feel that they have enough information to help them make a decision about moving to the home. People’s needs are assessed to make sure their needs can be met by the home. EVIDENCE: There is a Statement of Purpose for the home and this has recently been reviewed and updated. This includes the Aims and Objectives of the home. People told us that they had enough information to help them make a decision about moving to the home, including written information and being able to visit the home. Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 9 Only nine people were living at the home when we visited. The Owner said that some of the vacancies had been difficult to fill. He has applied to the CSCI to change the categories of registration so that the home can admit people who have dementia. In order to meet the needs of people with dementia, the staff need to be better trained and aware, activities need to improve, there needs to be better care planning and risk assessment, the environment needs to be improved to support orientation and to be made safe. We saw that basic needs assessments are made before people move to the home. Copies of these assessments are kept on their files. There are more detailed assessments made by the placing authorities which the home has copies of. There is evidence that placing authorities review the needs of people after they have stayed in the home for 6 weeks to make sure they are happy and their needs are being met. Redcotts DS0000017388.V361450.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Basic care plans are in place, however these lack detail about individual needs and are confusing in places. Care plans are not made in partnership with the people who they are about. Medication is generally well managed, however is not stored securely and record keeping needs improvement. People are not always treated with respect. Staff work with other professionals to make sure people stay healthy. EVIDENCE: Each person has a care plan. They do not have their own copy of these plans and all records are held in the staff office. People have not signed their care plans as a record of their agreement. There was no evidence that people Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 11 were involved in developing their own care plans or reviewing these. There was no evidence that their relatives or representatives had been involved. Care plans are reviewed and updated every month. Information within the plans is very basic and does not contain details on people’s choices or individual preferences. There is little or no information on people’s hobbies and interest. Where information about interests was recorded there was no evidence that people were supported to pursue their interests. Risk assessments are very basic. Information is not clearly presented in a meaningful way and scores are used to indicate risk rather than actually explaining what the risk is and how people can be supported to take risks. Some of the information in care plans was not recorded in risk assessment, for example where people had mobility aids or equipment. Some information in care plans is unclear. For example, one person’s care plan stated that staff should ‘provide a stick when needed’; there was no other information to support this statement. The person’s risk assessment did not mention any mobility needs or the use of a stick. Another person’s care plan stated, ‘wears glasses sometimes’, but did not indicate when they needed their glasses. Some people had more than one care plan in their file, because old information was mixed up with current information. The current care needed was not always clear. One person had an old care plan (May 2007) and risk assessment stating they were self medicating. The latest care plan (January 2008) stated that they needed staff to administer their medication. There was no other evidence to support a change in need and the care plan reviews which had taken place every month between these dates recorded no changes, even though this change in care is very significant. The staff work with other health care professionals to make sure people stay healthy. Everyone is registered with a local GP. District nurses visit the home to offer nursing support when this is needed. Relatives told us that they were usually informed when there was a problem with their relative’s health. One person said that they had to pay for a taxi for their relative to return home after a stay in hospital. There is a record of all accidents that have happened in the home and what action has been taken. These show that people have medical support when needed and that the staff take appropriate action to make sure people are safe and well following an accident. The cabinet used to store medication was not secured to the wall. The doors of the cabinet did not close properly and although locked, the cabinet was not secure. The lock had been tampered with and moved and the cabinet was only Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 12 secured by a small pad lock. The cabinet doors were scratched and marked where staff had forced the doors open when they locked the key in the cabinet by mistake. Not all medication records had been completed to evidence whether people had been given their prescribed medication. Some of the directions for administering medication were unclear. For example the instructions for one person’s medication were, ‘take as directed before’. The Manager must make sure the pharmacist provides clearer and more specific instructions. Internal and external medicines were stored together and should be kept separate. One person administers their own medication. The risk assessment for this was last undertaken in 2005 and needs to be reviewed. Receipt and amount of medication was not recorded on medication administration records. Where medication from the previous month was still in use this was not recorded as carried forward. There was a big bag full of old medication stored in the cabinet. There was no record of the contents of this. Unused medication must be returned to the pharmacist. There must be records of all medication held at the home. A staff notice board situated in an area used by all staff, residents and visitors included personal information about one resident. It is not appropriate to display this information in a public place. During our visit one person told the staff that they wanted to go for a rest. The staff member helped them to bed, but then left their bedroom door wide open. The bed could be seen from the corridor. The cleaning staff used the vacuum cleaner around someone who was eating their lunch and outside the bedroom of someone who was resting, with their bedroom door open. We saw that one person who had eaten their meal away from the main dinning room had done this independently. However, when a staff member came to take their plate away they told the person that they had left some food. They then stood over the resident and fed them the remainder of their meal. They did not ask whether the person wanted the rest of their food. They put each spoonful of food up to the person’s face until they ate it. The person’s care plan stated that they did not need assistance at mealtimes. Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 13 One member of staff told us that an NVQ assessor had visited the home and observed them supporting people with personal care. There was no evidence that the people who were being supported had given permission for this stranger to watch this. Alternative ways to assess staff performance should be sought. Residents must give permission and this must be recorded if an assessor observes them being given care. Bedroom doors had small stick on labels with people’s names on them. These were not clear to the people living in the room and were impersonal. The staff should ask people how they would like their room identified and whether the wish to have their name on their door. People should be offered the opportunity to choose a picture or symbol which would help them identify their room. Name plates and pictures should be attractive and meaningful for the person occupying the room. A sign on the kitchen door stated ‘staff only’. This should be removed. Access to the kitchen should be based on recorded risk assessments. One resident recently passed away. A member of staff had remembered a particular wish they had regarding their burial. The member of staff was making sure the people organising the burial knew this and carried out this wish. It is very good that they were making sure of this. However, the particular wish was not recorded in their care plan and should have been. Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are not supported to have fulfilling lives or pursue social interests which they have chosen. People can make some choices about their lives but these are limited. People are happy with some of the food that they eat but there needs to be more choice, variety, quality and information about food. EVIDENCE: The general atmosphere in the home seemed relaxed. However, the home was very quiet and one person told us that there was not a lot of organised things to do and no one to talk to. The Owner said that an Activities Coordinator visits the home for two hours twice a week. The diary indicated that she had not been able to visit the home every week. There was no evidence of the activities that took place during her visits or at any other time. Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 15 Care plans did not include any details on people’s personal interests or hobbies. There was no evidence to suggest that people had discussed individual interests. There was no evidence that people were supported to take part in activities outside the home. People are not supported to use the garden. There was no information on dates, events or people that are important for each individual. There is no information on people’s lives or personal histories before they moved to the home. During this visit and during our previous visits to the home no one was supported to pursue any activity. The TV in the lounge was left on at all times and no one was offered a choice of channel. The TV reception was fuzzy. Books in the lounge were not accessible as they were on a shelf behind the television. For much of the day some people sat in chairs in the lounge or hallway snoozing. The staff did not spend time talking to residents nor did they support them with any activity or social interest. One person said, ‘there needs to be more choice of the TV channels in the communal lounge’. There are no residents meetings. There is no evidence that people are consulted about the menu, activities, what they would like and changes to the home. The residents’ notice board did not have up to date or clear information. Visitors are welcome at any time and relatives told us that they were made welcome. We saw that staff were friendly and chatty to visitors. The lunch time meal for the day was recorded on a notice board, but there was no other information about the evening meal or meals for the coming days. There was no recorded choice for the lunch time meal. A member of staff is employed to cook lunch time meals throughout the week. She said that she knows the residents’ likes and dislikes. There was limited recorded information on people’s preferences. There was no snacks or fruit available for people to help themselves to and no snacks were offered while we were visiting. One person told us that the evening meal was not usually very good. This is often prepared by care staff. One person told us that some staff did not even know how to prepare simple meals like fish fingers or beans on toast. Some of the things people wrote in our questionnaires were: ‘A better selection of afternoon tea snacks should be available.’ ‘Meal portions could be bigger.’ ‘There needs to be a better choice of food available for people throughout the day.’ Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home and their relatives know how to make a complaint. There are procedures to protect people who live at the home. EVIDENCE: There is a complaints procedure. People told us that knew who to talk to if they wanted to make a complaint. We did not see evidence that there had been any complaints since we last visited the home. The staff we spoke to said that they had been on protection of vulnerable adult training. The home has agreed to follow the local authority protection of vulnerable adults procedure and staff are trained by the local authority. Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although there have been improvements to the environment, there is still outstanding work which is needed to make the building more accessible, safer and more homely. Some areas of the building are clean and well maintained however there needs to be further improvements to prevent the spread of infection. EVIDENCE: Over the past few years there have been a lot of improvements to the environment. Some new equipment has been brought. However, there is still outstanding work. Some of this is cosmetic and improvements would make the home seem more pleasant and homely. Some changes would improve the Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 18 quality of life for residents. And some improvements are necessary to make areas safe. The garden path is unsafe and residents cannot access the garden without support. The path is uneven and there is no railing for people to hold. There is not enough garden furniture for the people living at the home and is old, dirty and unsightly. One of the garden chairs is an old office chair. There are no shower facilities at the home and some of the baths are difficult for people to use. The Owner must provide accessible shower or bath facilities. Other repairs needed include: Replacing damaged flooring. Replacing damaged kitchen units and work surfaces. An unused bedroom containing old furniture and heaters was not locked and must be. Some changes would improve the look of the home. These include: The furniture in communal areas is not matching. Tables in the lounge are hospital type tables on wheels. nicer if replaced by more appropriate coffee tables. Some ornaments and pictures are old and do not match. Some paintwork is old and cracked or peeling. Radiator covers are not painted. The curtain on the back door does not fit. Furniture in a corridor was labelled to identify linen in each drawer- this is not very homely. The stair and landing carpet is old and marked in places. One bathroom door was wedged open in such a way that residents would not be able to close it, making this bathroom inaccessible to them. The home employs a cleaner. The home was generally fresh and clean and there were no unpleasant odours. However there were some areas of cleanliness which needed attention. These included: These would look Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 19 Some shelves and ornaments were dusty. The commode in one bedroom did not have a cover. Some toilets and bathrooms did not have soap or paper towels. One toilet did not have toilet paper. None of the bathrooms had liquid soap. Bars of soap are a risk for cross contamination and infection. There was a lot of limescale marking one bath and sink. Some plugholes were encrusted with hair and other dirt. Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels need to be assessed to make sure people are always safe. The deployment of staff does not meet the needs of the people living at the home. EVIDENCE: There were only nine people living at the home at the time of the inspection and therefore there were less staff than there would be if the home were full. On the day we visited three carers had helped people get up in the morning. Two carers were on duty for most of the day and one carer and the cook were on duty from 12-2pm. However, throughout the visit none of the carers spent time in the lounge with residents. The carer, cook and cleaner all took their lunch break at the same time, leaving no staff working. During the morning and afternoon staff spend time together rather than with residents. Staff attended to tasks, such as helping people to the bathroom at certain times, but were not always available in case someone needed them. They did not spend time talking to people or supporting social activities. Some of the residents, staff and carers felt that there are not enough staff. Their comments included, ‘there does not seem to be many staff around during the day’ and ‘there are not enough care workers’. We felt that the problem seems to be the deployment of staff rather than the actual staffing numbers. Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 21 Although the staffing levels from 12-2pm must be reviewed to make sure people are safe. One person told us that a lot of the staff have English as a second language and cannot always understand what the people who live at the home are saying to them. The staff told us that checks were carried out before they were employed and that these included a criminal records check. Some staff felt that they received good training for their roles and others did not. The staff told us that they did not have regular meetings with the Manager and that sometimes they did not have the information they needed. One member of staff who had been employed in the last year said that they had undertaken a range of relevant training and were doing an NVQ. The staff recruitment files and training records were locked away and only the Manager had access to these. Therefore we could not see evidence to check if the things we asked the home to do had been completed. The Owner should be able to access staff records in the absence of the Manager. There should be a clear and accessible record to show all the training the staff have completed. The Manager and staff need specific detailed training in caring for people who have dementia if the Owner wishes to offer this type of care at the home. The training must be implemented at the home including how people are cared for and supported and how their care needs are recorded. Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is appropriately managed but there are not good procedures to make sure the home is run appropriately in the absence of the manager. The communication with and support of staff needs to improve. People are not kept safe because checks on health and safety are not carried out. EVIDENCE: Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 23 The Manager has been in post since 2007. She has been registered with the Commission for Social Care Inspection. Since she has been in post she has made lots of improvements to the home and the way in which staff work. The Manager was away for an extended period of leave at the time of the inspection. There was no arrangements in place to allow the Owner access to residents’ money or staff files and training records. The Owner did not know where residents’ contracts were nor did he know whether he had been given a key to access certain records. There is no Deputy Manager at the home and no member of staff had been given responsibilities to oversee the running of the home in the absence of the Manager. There is no petty cash for staff to use. One member of staff had to use their own money to pay for something and was then reimbursed by the Owner. The staff said that they were always reimbursed, however the system is not appropriate and staff should not have to pay for items with their own money. The Owner visits the home often and makes a record of his visits once a month, when he speaks to staff and residents and looks at records. The Manager does not have any professional supervision or guidance. The Owner should consider employing a mentor to offer the Manager professional supervision and support. The Manager needs to undertake an NVQ Level 4 or equivalent qualification. Residents or their representatives look after their own money. The home looks after small amounts of cash for some people. The Manager is responsible for keeping this safe and maintaining records. The Manager was away for a month at the time of the inspection visit and no one else could access this money. Therefore we could not check that this was being looked after properly. It also meant that people could not have access to their own money. One person’s relative gave a sum of cash to staff during the time the Manager was away. A member of staff said that they had hidden this and that no one else knew where it was. There was no official record of receipt of this money. The procedures for safeguarding residents’ money must be improved so that there are clear accurate records. There must be a procedure for another designated person to access the money in the absence of the Manager. Residents must be able to access their own money whenever they wish to. There was a record of one staff meeting in November 2007. The staff said that they did not have regular meetings. The minutes of this meeting indicated that there had been no discussion or opportunities for staff to share their feelings and experiences or raise any items for the agenda. There must be regular meetings for staff, which include opportunities discussion and for everyone to raise agenda items. Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 24 The staff we met and those who completed questionnaires told us that they did not have regular individual meetings with their manager. There was no evidence of regular, formal, planned supervisions. The staff notice board was located in a corridor in the home which is used by everyone. This is not an appropriate location. The notice board included a memo to staff which threatened them with suspension if they did not sign up to NVQ training. The tone of this memo was not appropriate. Any disciplinary issues must be addressed to individual staff members through meetings and these must be recorded. There was no evidence of health and safety, safe water temperature or fire safety checks. There are no recorded checks on first aid supplies to make sure the contents were sufficient and in date. There was no evidence of fire drills. The Owner and staff we spoke to did not think any of these checks took place. The fire extinguishers were due for retesting. There was no record of electrical appliances being tested since 2005. Some of the radiator covers were not properly secured. The Environmental Health Officer visited the home in September 2007. They had a lot of concerns about the way in which food was stored and prepared. These included inadequate training for staff, problems with the environment, insufficient cleaning and insufficient checks on food. Some of these issues had not been addressed and must be. Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 25 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 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 3 X 2 2 X 2 Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 12 Requirement Timescale for action The Registered Person must 30/06/08 make sure residents (or their representatives) are involved in developing and reviewing their care plans. They should have a copy of these and information should be clear and accessible to them. They should sign their care plans as a record of their agreement. 2. OP7 15 The Registered Person must 30/06/08 ensure care plans are clear, accurate and appropriately detailed. Changes must be recorded and old information should be archived. The Registered Person must 31/05/08 make sure risk assessments are accurate, regularly reviewed and meaningful. 3. OP7 13 15 Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 27 4. OP9 13 The Registered Person must 01/05/08 make sure the medication cabinet is secured. The Registered make sure: Person must 15/05/08 are 5. OP9 13 Medication records completed accurately. Instructions for administration of medication are clear. Medication appropriately. is stored All medication is recorded, including receipt of medication, medication carried over and medication awaiting disposal. Unused medication is returned to the pharmacist. 6. OP10 12 The Registered Person must 01/05/08 make sure personal information about residents is not displayed in public places. The Registered Person must 01/05/08 make sure staff respect people’s privacy and dignity at all times. The Registered Person must 01/05/08 make sure staff follow care plans and only support people at mealtimes when their help is needed. They must support people appropriately by sitting with them for the duration of the meal and allowing them to make choices about how much and what they eat. 7. OP10 12 8. OP10 12 Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 28 9. OP12 16(m) The Registered ensure that: Person must 31/07/08 Detailed information on social needs and interests is in place for all residents. A wider range of activities and outings is available to residents. Staff encourage and support residents to meet their social and leisure needs throughout the day. Residents who have a disability have opportunities to participate in activities of their choice. This Requirement has been made at previous inspections. 10. OP14 16(h) The Registered Person must ensure that residents have access to the kitchen if they wish. Risk assessments or support plans should be developed where necessary to enable this to happen safely. This Requirement has been made at previous inspections. 11. OP14 12 The Registered Person must make sure people are able to participate in decisions about their lives and the home, including care plans, menus, activities and events in the home. The Registered make sure: Person must 31/05/08 31/05/08 12. OP15 16 31/05/08 Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 29 The menu is displayed. People are able to make choices at mealtimes. The food is always well prepared and good quality. Snacks and fruit are available at all times and that people are offered these. 13. OP19 23(2) The Registered Person must make sure the gardens and pathways are safe and accessible to residents. This Requirement has been made at a previous inspection. 14. OP19 23(2) The Registered Person must ensure that accessible bath and shower facilities are available to residents. This Requirement has been made at a previous inspection. 15. OP19 23 The Registered Person must complete other environmental needs identified in the report. 23 The Registered Person must make sure bathrooms and toilets are cleaned thoroughly and are supplied with toilet paper, liquid hand soap and paper towels at all times. 31/08/08 31/08/08 31/07/08 16. OP26 31/05/08 17. OP27 19 The Registered Person must 15/05/08 make sure the staffing levels are safe at all times and that staff DS0000017388.V361450.R01.S.doc Version 5.2 Page 30 Redcotts are deployed appropriately. 18. OP28 18(1) The Registered Person must support staff to undertake and 31/08/08 achieve NVQ Level 2 or above. This Requirement has been made at a previous inspection. There was insufficient evidence to show whether this requirement had been met at this inspection. 19. OP29 19 The Registered Person must make sure that the home obtains 31/08/08 appropriate documents for all staff, including Criminal Records Bureau disclosures specifically for this post, proof of identity and references. This Requirement has been made at a previous inspection. There was insufficient evidence to show whether this requirement had been met at this inspection. The Registered Person must make sure all staff have received 31/08/08 training in First Aid, food hygiene, health and safety and fire safety. This Requirement has been made at a previous inspection. This Requirement has been made at a previous inspection. There was insufficient evidence to show whether this requirement had been met at this inspection. 21. OP30 18 The Registered Person must 30/09/08 make sure all staff are trained in caring for people with dementia if people with these needs are DS0000017388.V361450.R01.S.doc Version 5.2 Page 31 20. OP30 18(1) Redcotts going to be admitted to the home. 22. OP32 8 The Registered Person must 31/05/08 make sure there are arrangements for the day to day running of the service in the absence of the Manager. The Manager must commence NVQ Level 4/the Registered 30/09/08 Managers Award. This Requirement has been made at a previous inspection. 24. OP35 12 20 The Registered Person must 15/05/08 make sure people can access their own money whenever they wish to. The Registered Person must make sure the manager has 31/08/08 access to planned regular, professional support and supervision. This Requirement has been made at a previous inspection. 26. OP36 34 The Registered Person must 31/05/08 make sure staff disciplinary issues are dealt with appropriately following the disciplinary procedure. The Registered make sure that: Person must 15/05/08 23. OP31 10(3) OP36 25. 12(5) 18(2) OP38 27. 23(4) Fire drills and checks on fire equipment are recorded. Fire procedures are clear and well known by staff. This Requirement has been Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 32 made at a previous inspection. 28. OP38 13 The Registered Person must 15/05/08 make sure all areas of health and safety, including first aid supplies, general health and safety and portable appliance testing are carried out regularly and are recorded. 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. Refer to Standard OP8 Good Practice Recommendations The Registered Person should consider paying for any travel costs for residents returning from hospital. The Manager should review the risk assessment for the person who manages their own medication. People living at the home should be given a choice about how they want their room identified. Pictures, name plates and other symbols should be attractive and meaningful to the person occupying the room. The Manager should consider organising training for staff on how to support people at mealtimes. The staff should make sure individual wishes about death, dying and burial are recorded. There should be a range of resources which people can use to pursue leisure interests and these should be accessible to everyone. DS0000017388.V361450.R01.S.doc Version 5.2 Page 33 2. OP9 3. OP10 4. OP10 5. OP11 6. OP12 Redcotts 7. OP14 The Manager should consider holding regular residents meetings so that people are well informed and able to be part of decision making at the home. Meal portions should be appropriate for each individual. The garden furniture should be replaced. Paint the radiator covers to improve their appearance. Replace the worktops and flooring in the kitchen. The Registered Person should make sure the home is thoroughly clean throughout. 8. 9. 10. 11. 12. OP15 OP19 OP19 OP19 OP26 13. OP27 The Manager should make sure the staff can understand and communicate effectively with residents. Consider the appointment of a deputy manager to sustain the rate of improvement. 14. OP36 Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 34 Commission for Social Care Inspection London Regional Contact Team Fourth Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Redcotts DS0000017388.V361450.R01.S.doc Version 5.2 Page 35 - 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. 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