Inspection on 16/11/06 for Redcourt Care Home

This inspection was carried out on 16th November 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Redcourt Care Home 15/10/08

Redcourt Care Home 30/04/07

Redcourt Care Home 19/12/05

Redcourt Care Home 30/08/05

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

CARE HOMES FOR OLDER PEOPLE Redcourt Care Home 2 Carnatic Road Liverpool L18 8BZ Lead Inspector Natalie Charnley Unannounced Inspection 10:00 16 November 2006 th 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 Redcourt Care Home DS0000063012.V311218.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. Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redcourt Care Home Address 2 Carnatic Road Liverpool L18 8BZ 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) 0151 724 1733 Argyle Care Group Limited Dawn Marie Wake Care Home 51 Category(ies) of Dementia - over 65 years of age (51) registration, with number of places Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection October 2005 Brief Description of the Service: Redcourt Care Home is a large establishment providing personal care for up to 51 older persons with organic mental disorders. The home consists of two units one of which is the original build of many years ago, called Claret, and a newer building, known as the Mews. Both buildings have lounges, dining rooms, and quiet areas for service users. Bathrooms and toilets are on each floor. Bedrooms are fully furnished with carpets and curtains, and fitted furniture, some residents have personalised their own rooms. There is a large internal/secure garden and courtyard as well as external garden area. The home is situated in a quiet residential area close to Sefton Park and the local amenities. The home has off road parking. It costs from £385 per week to live at the home. Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. 1 inspector visited the home to carry out the site visit. This was carried out over a period of one day. The inspector arrived at the home at 09:00 and left at 15:00.The inspector spoke with 5 staff, the home manager, the deputy manager and 12 residents, and 3 visitors. The inspector completed the inspection by looking at the homes records, a tour of the building, formal and informal interviews and information from previous inspection reports. The inspector followed an inspection plan written before the start of the inspection using all information held on file at the Commission for Social Care Inspection regarding the home, to ensure that all areas that needed covering were done so. Feedback was given to the deputy manager during and at the end of the inspection. The manager was present for the final feedback session at the end of the day. This report is based on pre inspection information provided by the home as well a site visit. Discussion took place with regard to how the home deals with equality and diversity. The manager was able to give examples of how they had addressed this in the past and evidenced a variety of policies and procedures for both staff and residents. What the service does well: Care plans and assessments are of a good standard. Details of residents diagnosis of dementia and care needs for their dementia are well recorded. Residents and visitors are happy with how the home operates. Comments were recorded in the home compliment book such as “the whole of the staff are very caring and make everyone’s stay very nice” and “I am delighted to see how well my relative has settled in here”. Training is given to staff on a variety of subjects. This helps them in ensuring they provide a high standard of care. The home monitor the quality of the care they give well. The procedure is open and transparent, allowing everyone to see the changes that are made. Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Redcourt Care Home DS0000063012.V311218.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 Redcourt Care Home DS0000063012.V311218.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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information gathered by the home before resident moves in, ensures that they can care for residents appropriately. EVIDENCE: The home assesses all residents before they move into the home. This is to make sure that they can meet their needs. An assessment was sampled for a resident who had moved into the home a few days previously as well as another 4 people who live at the home. The assessments showed that the home had details of residents physical and mental health. Details regarding their diagnosis of dementia were comprehensive and clearly showed what support staff would need to provide. Staff had also noted what residents could do for themselves in order to promote independence. Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 9 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 and 10 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Care plans detail how staff are to care for residents. Recording of medication administration must be improved to ensure the safety of residents. Residents feel they have their dignity and privacy maintained. EVIDENCE: 6 care plans were sampled in total during the inspection, from different units of the home. All plans were being reviewed on a monthly basis to keep them up to date. A ‘getting to know you’ form is completed by the family of residents or by staff. This is a booklet that details what a resident has done during their life and their likes, dislikes and daily routines. This is an example of good practice as it allows staff to be able to provide individual care. Care plans had a section for the resident or family to sign to say that they agreed with the care plan. None of the care plans looked at had been signed. The manager may wish to address this in the future. Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 10 Residents have access to a range of health professionals such as dentists, opticians and dieticians. Records of these visits are well recorded and show the outcome of the visit. Risk assessments are carried out for all residents and were found to be regularly updated. Daily notes were also very detailed, showing exactly what residents had done on a particular day, including joining in with any activities. Medication storage, recording and administration practices were checked during the visit. All medication records that had been written by hand only had the signature of 1 member of staff; some records did not have any signatures at all. This is a dangerous practice and leaves residents at risk. If the records are signed by 2 members of staff, this allows an extra check to ensure the record has been written correctly. 4 residents had not been given their medication as it had been prescribed. These short falls were shown to the deputy manager who was going to address them with staff. This practice also leaves residents at risk. Staff were found to be recording ‘0’in records and not defining why medications had been omitted. 3 variable doses of medication were not recorded correctly, meaning that staff were unsure what dose had been given. Storage of medications was satisfactory and staff have received training. A list of medications was available in the records as a simple guide to what medications are used for and what the common side effect are. This is an example of good practice. Residents and visitors spoken to stated that they felt that staff were always kind and respectful. Observation of staff showed that on the whole, staff maintained the privacy and dignity of residents. Staff were noted to be addressing individuals in an appropriate way, however on 2 occasions it was noted that staff were talking about other residents in a communal area. Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 11 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 and 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Activities are varied and suit the needs of individuals. Residents enjoy a flexible lifestyle and are supported to make choices. Meals are balanced and varied. EVIDENCE: The home has an activity plan that is available for residents. This shows that activities are available in the home as well as some outside the home. One of the care assistants is responsible for organising activities and making sure they are recorded when residents attend or join in. Activities vary on different units. Plans are made dependent on the wants and needs of the residents who live on the units. The male residents particularly enjoy darts and watching ‘Dads Army’ where as the ladies enjoy pampering sessions and reminiscence. Some activities are also made available for everyone at the home, such as the musical entertainment on the day of the visit. Visitors confirmed that they are welcomed at the home at any time. They are able to join in with activities and meet their relatives in private areas of the home if they wish. Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 12 Residents were observed to be able to make decisions at the home. They were asked where they would like to sit in the lounge, what they wanted for lunch and if they wanted to attend the musical entertainment. The menus at the home rotate over a 2-week period. This is to ensure that tastes regularly change. Menus are available in the units that tell residents what is available. Residents and staff confirmed that they can choose and alternative if they don’t like what is on offer. Residents commented, “ the food is nice” and “ it’s tasty”. One visitor commented that since moving her relative to the home, he has begun to feed himself. She was happy that staff had encouraged and supported him to do this. Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 13 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 and 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Complaints are dealt with well at the home. Staff are made aware of the responsibilities in looking after residents and are all checked to ensure they are suitable to work with the residents at the home. EVIDENCE: Since the last inspection, 6 complaints have been received at the home. Records showed that these were dealt with appropriately and within a short period of time. One problem that arose from the complaints related to a backlog of ironing at the home. Since this has been raised, a new member of staff has been employed, specifically to do the ironing at the home. A complaints policy is located around the home and was sent out to all relatives with the last home newsletter. The home and staff working there have access to a copy of the local authority adult protection guidelines. This is used if an allegation of abuse is made. Staff spoken with stated that they had read this policy. All staff employed at the home had a police check carried out on them to ensure that they are suitable to care for vulnerable adults. General advice was given to the home regarding the storage and safekeeping of these documents to ensure confidentiality. Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 14 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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements are being made to the home and residents enjoy living there. The manager needs to address areas of potential hazards to residents safety. EVIDENCE: A tour of the home was carried out during the site visit. The home was clean and tidy, however a malodorous smell was identified on the green corridor. The deputy manager addressed this during the inspection. New lounge chairs had been purchased for blue, pink and terracotta units, in order to create a more homely atmosphere. A designated smoking area is available to residents in the home conservatory; all other areas of the home are non-smoking. Whilst sitting in the claret lounge, it was noted that the large radiators that are located by the window were extremely hot to the touch. This is a possible hazard to residents. Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 15 The manager must address away of ensuring this area is kept safe. Around these radiators it was noted that the carpet was heavily stained and in need of deep cleaning. Residents, staff and visitors were happy with the environment of the home. Comments were made such as “ its homely here”, “I like it” and “ residents are free to go all over the home, staff just keep an eye on them”. Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 16 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 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents feel well cared for by staff. Staff are well trained and work well as a team. The manager ensures that staffing levels are kept under review to ensure safety needs are met at all times. EVIDENCE: Staff at the home are allocated to work on the same units on a regular basis. This is to ensure that residents get a continuity of care. Staff employed at the home, who have English as a second language are supported by the home to do basic maths and English classes. Observation around the home showed that there were no problems with staff communication. Staff were polite and spoke to residents in a clear and calm way. Residents appeared fond of the staff that cared for them and described them as “fantastic” and “ nice people”. Rotas at the home show that there enough staff on duty to meet the needs of the residents who live there. The care staff are supported by 2 chefs, 1 kitchen assistant, 5 housekeepers, 1 ironing lady and a handy man. This ensures the smooth running of the home. Both the manager and deputy manager work supernumerary hours. This allows them time to ensure standards are maintained and that care is being carried out, as it should be. Information supplied by the home, showed that 30 of staff hold a specialist NVQ (national vocational) qualification. This is short of the required 50 and must be addressed by the home as it may impact on the care of residents. Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 17 Other training that staff have attended include challenging behaviour, managing dementia, elder abuse and manual handling. Staff have also attended a specialist course run by the Alzheimer society. Staff feel that they are given a good standard of training and that these are well run. The home has a designated training manager who ensures that all training is kept up to date and is suitable for staff. 4 staff files were sampled. This showed that staff have a good induction, a job description, 2 references and a CRB (criminal records) check to show that they are suitable to work at the home. These records are kept in a confidential location at the home. Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The manager is competent and qualified to run the home. She monitors quality of the home on a regular basis. The recording of residents money ensures the residents remain protected. EVIDENCE: The home manager is a qualified nurse who also holds a specialist management qualification. She has worked in care for several years and is registered with the Commission for Social Care Inspection. Staff, visitors and residents spoke highly of the manager stating she was “approachable”, “ easy going” and “really nice”. The manager is responsible for ensuring the standards at the home. Annual surveys are sent out to relatives and health professionals to ask for their opinions on the home. Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 19 The manager stated that when this was last done in April 2006, they had a poor response. Results were taken from the forms returned and published around the home and sent to all families. The results showed that nearly all questions had been rated as ‘excellent’ or ‘very good’. Protected meal times have also been introduced as a result of quality assurance work. This allows residents to have their meals in peace, without being disturbed by visitors. Staff report this working very well. The home is responsible for the finances of 5 residents. Records showed that appropriate recipes and information are kept, and that wherever possible, responsibility is passed to families. This protects the welfare of residents. Records sent to the inspector and records seen during the site visit showed that all health and safety checks are being carried out at the home. Staff receive regular updated on fire drills and accident records comprehensive. Health and safety training is given to staff on a regular basis to ensure they can protect the residents from harm. Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 21 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. 1. Standard OP9 Regulation 13(2) Requirement The registered person must ensure all medications are given as prescribed. Handwritten records must be double signed and variable doses of medication recorded. This is to ensure the health and well being of residents. The registered person must ensure that the radiators in claret lounge are protected to ensure they don’t pose a risk to residents The registered person must ensure that the malodorous smell to the green corridor is addressed Timescale for action 20/11/06 2 OP19 13(4)(a) 15/12/06 3 OP21 16(2)(j) 01/01/07 Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 3 Refer to Standard OP7 OP19 OP28 Good Practice Recommendations The home may wish to consider how they involve residents and their families in the care planning process, and how this is recorded. The home may wish to deep clean the carpet by the window in claret lounge The home may wish to address how they intend to meet the required target of 50 of staff trained to NVQ level 2 0r above Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Redcourt Care Home DS0000063012.V311218.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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