Inspection on 18/01/08 for Redfern

This inspection was carried out on 18th January 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Redfern 20/11/06

Redfern 18/08/06

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Redfern 6 St Vincent Terrace Redcar TS10 1QL Lead Inspector Ray Burton Key Unannounced Inspection 18th January 2008 09:30 Redfern DS0000066806.V352969.R01.S.doc Version 5.2 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 Redfern DS0000066806.V352969.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 Adults 18-65. 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. Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redfern Address 6 St Vincent Terrace Redcar TS10 1QL 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) 01642 487766 F/P 01642 487766 redfern@milewood.co.uk Milewood Healthcare Limited John Robert Storr Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Accommodation to be provided for a named individual over the age category of 65 plus. 20th November 2006 Date of last inspection Brief Description of the Service: Redfern is a terraced house situated in a quiet residential street in Redcar and is indistinguishable from other homes in the vicinity. The home is registered by The Commission for Social Care Inspection to provide accommodation for up to seven service users who have a learning disability. There are seven bedrooms all of which have en suites. Communal facilities comprise a dining room and sitting room. Externally there is a small front garden to the property and a large yard to the rear, which has been made into a courtyard style garden with a seating area. The property is near to local train and bus networks. Redfern DS0000066806.V352969.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 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced inspection covering all of the key standards of the National Minimum Standards for Care Homes for Adults. The inspection commenced on 18th January and was completed on 24th January 2008. During the inspection a tour of the building was conducted, records and care plans examined and the inspector spoke to service users, the manager and members of staff. What the service does well: What has improved since the last inspection? All but one of the issues highlighted in the last inspection report had been suitably addressed: Medication storage facilities have been improved; the homes statement of purpose has been reviewed; the manager has been registered with the CSCI. Redfern DS0000066806.V352969.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. The summary of this inspection report can be made available in other formats on request. Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4. People who use this service experience adequate quality outcomes in this area. The home had not always conducted thorough pre-admission assessments to ensure only those people whose needs could be met would be admitted. We have made this judgement using a range of evidence, including a visit to the service. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Since the last inspection the homes statement of purpose had been reviewed and updated. The service users guide was written in a user-friendly format however the manager said that some of the service users had a higher level of literacy and did not require a simplified version of the guide; therefore it was his intention to develop an alternative document that would better reflect their ability level. The importance of the home conducting a robust assessment procedure to determine the suitability of the placement, the ability of staff to meet identified needs of prospective users of the service, and compatibility with existing service users was highlighted in a previous inspection report; which found that not all files contained evidence that such assessments had been carried out. Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 9 It was disappointing therefore to discover that since the last inspection a service user had been admitted to the home without adequate assessments being conducted; however conversation with the manager during this inspection and examination of the file belonging to a prospective user of the service, currently undergoing assessment, revealed an improvement in the homes pre-admission procedure. A multi-disciplinary approach had been adopted with good background information having been received from relevant professionals such as a Community Psychiatric Nurse, social worker etc. The Manager and Deputy had visited the prospective service user and conducted an initial assessment; he had then made two visits to meet the people living in the home and also members of staff. During one of the visits he had viewed the room he was to occupy should he become resident in the home and had chosen the colour scheme The manager said the assessment was ongoing and more visits would be made by the individual to allow staff further opportunity to complete the assessment process. Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. People who use the service experience good quality outcomes in this area. The homes care planning process ensured service users needs were identified and met. Residents were consulted about all aspects of their life and were supported to be as independent as possible. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: Three care plans were examined as part of the inspection process; each contained good background information and assessments covering all areas of daily living and personal need. Ongoing assessments had been received from various relevant professionals such as Community Psychiatric Nurses. Regular monitoring and reviews of care plans involving the service user, appropriate professionals and members of staff from Redfern ensured changing needs were identified and suitable plans made to meet the need. Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 11 The following comments were made in questionnaires returned as part of the July 2007 Quality Survey: “You liaise well with all members of the multi-disciplinary team. You provide consistency and continuity that clients require.” (Community Nurse) “Working well with the Learning Disability Forensic Team and communicating any concerns or issues as and when appropriate” (A Social Worker) The home had developed a person centred approach to care planning and each user of the service was encouraged to take part in the process, make choices about their lives and achieve as high a level of independence as was possible. A person centred planning booklet had been developed for each service user; the document was written in a user-friendly way and the individual was encouraged to use the book to record aims and aspirations etc and to ensure their wishes were central to their plan of care. Risk assessments were in place and risk management strategies had been developed to eliminate or reduce identified risk. Service users had signed to signify their involvement in, and agreement to, the process. Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17. People who use the service experience good quality outcomes in this area. Users of the service were treated with respect and presented with opportunities to lead fulfilling lives. They were encouraged to take part in appropriate leisure activities and supported to engage in community-based activities. This judgement has been made using available evidence including a visit to the service. EVIDENCE: There was a relaxed and friendly atmosphere in the home, service users appeared at ease with each other and with members of staff. Routines were flexible, promoted independence and allowed users of the service to exercise personal choice and control over their own lives, subject to their individual plan. Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 13 Each bedroom door had been fitted with a lock and the occupant provided with a key. It was observed throughout the inspection that members of staff sought permission before entering a service users room. The Annual Quality Assurance Assessment (AQAA) completed by the registered manager stated that each user of the service had an activity planner detailing activities in which she/he engaged, these included such things as: visits to cinema, leisure centres, pubs, social clubs etc. Conversation with service users and members of staff and examination of activity planners and daily records confirmed service users enjoyed a wide range of different activities both in-house and in the community e.g. TV and videos, arts & crafts and computer skills at a local college of further education, swimming, bingo. One service user was a member of a local history group at the local library. Annual holidays were arranged to suit the wishes and interests of individual service users; last year one service user went on a Mediterranean cruise; others went on a self-catering holiday in Wales. A service user commented that she liked all members of staff and said: “I don’t think I’ve ever been so happy, it’s a lot to do with the atmosphere in the home. I can have a joke with the other people I live with. I never want to move from here.” Staff supported service users to maintain family and friendship links both inside and outside of the home, subject to any restrictions agreed in individual care plans. Menus showed service users were offered a varied and balanced diet. Alternatives were always available should someone not wish to have the meal of the day. Residents were involved in menu planning and, where appropriate, meal preparation. Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. People who use the service experience good quality outcomes in this area. Healthcare and personal needs were met by staff who provided support in a sensitive and flexible manner in accordance with the wishes of the individual service user. Appropriate healthcare professionals provided advice and additional support. The systems for managing service users medicines were good. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: Each care plan examined contained detailed information about service users general health, dietary requirements and details of any specific ailment or medical condition. Daily records provided good up-to-date information about service users mental and physical health, mood etc. Service users had access to ordinary community-based health services as well as specialist services where necessary. Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 15 Staff understood the importance of delivering personal support in a sensitive and flexible manner and of consulting with service users and supporting them to maintain as much independence and control over their own healthcare as possible. None of the current users of the service managed their medication, however each had been asked if they wished to hold their own medicines and had been assessed for their ability to safely manage them. All medicines were administered, according to the homes policies and procedures, by members of staff who had received appropriate training and had been assessed as being competent, in the administration of medicines. Appropriate records were kept and all medicines were suitably stored. A daily stock check of all medicines held in the home was undertaken. Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. People who use the service experience good quality outcomes in this area. The home had a suitable complaints procedure and policies and procedures to safeguard service users from abuse. Staff had received training in adult protection. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: The home had an appropriate complaints policy and a procedure (available in user-friendly format) stating how complaints could be made, who would deal with them, the timescale for the process and what to do if not satisfied with the way in which the matter had been handled. The procedure was displayed in the homes entrance hall and each resident, upon admission, had been given a copy. A service user told the inspector that he was very satisfied with life at Redfern and had no complaints. He said the complaints procedure had been explained to him. Policies and procedures were in place to safeguard service users and to protect them from abuse. A copy of the “No Secrets” adult protection protocol was available to staff, all of who had received appropriate training in the Protection of Vulnerable Adults (POVA). Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28, 29, 30. People who use this service experience good quality outcomes in this area. Redfern provides comfortable and homely accommodation and meets the needs of the people who live there. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: Redfern is conveniently situated within easy walking distance of local amenities and has garden to the front of the house and an enclosed garden/yard area to the rear of the property. A walk around the building revealed it to be clean, hygienic and free from offensive odours; the internal and external fabric of the building was maintained in good condition. Décor throughout was pleasant; furniture in communal areas was domestic in nature and suitable for purpose. All areas of the building including the kitchen and laundry were accessible to service users, subject to individual risk assessments. Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 18 Bedrooms were comfortably and suitably furnished and each had been provided with an en-suite facility. As part of the admission process each prospective service user was given the opportunity to view the room they would occupy and was encouraged to choose the layout, furniture and décor. All areas of the home were centrally heated and radiators had been covered with suitable guards to ensure a low surface temperature. Hot water outlets accessible to service users had been fitted with pre-set valves to provide safe water temperatures. First floor windows had been fitted with restrictors. Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 . People who use this service experience good quality outcomes in this area. People using the service are protected by a competent staff team and by the homes policies and procedures on recruitment and training. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: On the days of the inspection there were sufficient members of staff on duty to meet the assessed needs of service users. Examination of staffing rosters indicated the home always had a minimum of four staff on duty at any one time during the day; two members of staff provided waking overnight cover. Examination of personnel files evidenced that, prior to a new member of staff commencing employment, the home obtained two suitable references and conducted all necessary checks including Criminal Records Bureau (CRB). Training records and conversation with the manager and members of staff revealed the home encouraged members of staff to undertake training that would aid their professional development and help them meet service user’s Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 20 needs. In addition to mandatory training, recently completed training included: ADHD, Stigma, Abnormal Psychology, POVA. Four members of staff had gained the NVQ level 2 in care and five were currently registered for the award and working toward completion. The Deputy Manager was the holder of NVQ level 3 and was working toward gaining a NVQ level 4 in Care. Each member of staff received at least six formal supervision sessions per year. In conversation with the inspector service users made some very positive comments about life at the home and about members of staff. Remarks made in the July 2007 Quality Assurance survey included: “They are all very nice and kind. My key workers are the best.” “Mint! Brill! All staff are the best.” Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 42. People who use this service experience good quality outcomes in this area. A well managed home. The health, safety and welfare of service users are protected by the homes record keeping and policies and procedures. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: This is a well managed home. Since taking up his post the registered manager has worked hard to develop a strong and stable staff team; he does not yet hold the necessary qualifications in care and management, however he is currently working toward achieving the Registered Managers Award and, upon completion, intends to undertake the NVQ 4 in Care. Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 22 Suitable policies and procedures were in place covering all aspects of the management of the home. Records were kept to safeguard service users rights and best interests and to ensure the safe and effective running of the home – these were up-to-date and accurately maintained. Members of staff were aware of their responsibilities under Health & Safety legislation. Regular checks of the building and equipment were conducted and maintenance and servicing undertaken to ensure a safe and comfortable environment. There were various quality monitoring systems in place to measure success in meeting the homes statement of purpose and aims and objectives: informal feedback from service users and their relatives, staff meetings, staff supervision sessions and monthly service reviews conducted by the Operations Manager. Twice yearly quality assurance questionnaires were sent to service users and their families, appropriate professionals including doctors, community nurses, social workers and advocates. Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 2 3 2 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 3 3 3 3 3 X Redfern DS0000066806.V352969.R01.S.doc Version 5.2 Page 24 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 YA2 Regulation 14 (1) Requirement The registered person must ensure the comprehensive assessment of the resident’s aspirations and complex needs, which is undertaken by staff, is recorded prior to a resident’s admission. (Previous timescale 01/04/07) Timescale for action 01/02/08 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 YA37 Good Practice Recommendations To meet the National Minimum Standard the Registered Manager should achieve a suitable qualification in both care and management. 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