CARE HOMES FOR OLDER PEOPLE
Redholme Forest Road Whitehill Bordon GU35 9BA Lead Inspector
Beverley Rand Unannounced Inspection 24th January 2006 10:15 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 Redholme DS0000012156.V279293.R01.S.doc Version 5.1 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. Redholme DS0000012156.V279293.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Redholme Address Forest Road Whitehill Bordon GU35 9BA 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) 01420 472 467 Mr Hurryprasad Matadeen Mrs Ermelinda Matadeen Mr Hurryprasad Matadeen Care Home 5 Category(ies) of Old age, not falling within any other category registration, with number (5) of places Redholme DS0000012156.V279293.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 12th July 2005 Brief Description of the Service: Redholme is a detached house situated in a quiet residential area, a short walk from the village of Whitehill. The owners live on the premises and personally provide the care needed to meet the needs of the service users; care/domestic staff are not employed. The home provides a residential service to up to five older people who are actively encouraged to maintain their independence. Redholme DS0000012156.V279293.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was the second unannounced inspection of the year and looked at fourteen key standards. This report should therefore be read in conjunction with the previous report. The inspection took place over two hours and the inspector spent time talking with four residents and looking at records such as care plans. What the service does well: What has improved since the last inspection? What they could do better:
The home has not undertaken assessments regarding the storage and safety of various cleaning fluids, and this report says they must do this, and take any action if necessary to ensure that residents could not be harmed. Redholme DS0000012156.V279293.R01.S.doc Version 5.1 Page 6 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. Redholme DS0000012156.V279293.R01.S.doc Version 5.1 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 Redholme DS0000012156.V279293.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Standard 6 does not apply The manager ensures that no one moves into the home without completing an assessment and being sure that the home can meet their needs. EVIDENCE: The manager visits prospective residents in hospital or wherever they are, and completes an assessment. The inspector saw an assessment which covered all the necessary aspects. Redholme DS0000012156.V279293.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9 & 10 The home ensures that care plans are in place, that privacy and dignity is respected and that residents are protected by medication procedures. EVIDENCE: Care plans are thorough, identifying individual preferences and needs, and are reviewed on a monthly basis. The home uses blister packs for medication which are filled by the pharmacist. Mr Matadeen described an appropriate procedure used for dispensing medication, and both he and Mrs Matadeen completed the Safe Handling of Medicines course last year. Mr Matadeen gave examples regarding how residents’ privacy and dignity is maintained. He and his wife knock on doors before entering rooms, and Mrs Matadeen supports female residents with personal care if necessary. Residents said Mr and Mrs Matadeen are, ‘always polite, couldn’t say enough about that, wonderful’, and that they did not, ‘make you feel guilty’ if support was needed. They also said they were looked after, ‘most attentively’.
Redholme DS0000012156.V279293.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 & 15 The home ensures that residents lead the lifestyle they choose, and residents enjoy the food, although some would like something different for tea. EVIDENCE: Mr Matadeen said that there used to be singers who visited the home but residents did not enjoy this activity. Holy Communion was held on the day of the inspection, and some residents attend a church function once a month. Some residents go out independently for recreation, others choose not to. Residents watch television or listen to radio, and none of them wished for any further activities to happen. Residents said they could decide when to go to bed. Residents are able to bring personal possessions into the home when they move in, or at a later date. Residents manage their own money if they are able, or family manage. Residents said they enjoyed a traditional Christmas dinner and the food was very good. One resident was pleased with the, ‘beautifully cooked fish and chips’ they had on Fridays, another particularly enjoyed apple tart. Two residents were less pleased with the teatime menu, which consists of
Redholme DS0000012156.V279293.R01.S.doc Version 5.1 Page 11 sandwiches: they felt there was not enough meat in the sandwiches, and would like bacon and egg or tomato soup sometimes. A third resident liked the sandwiches. The inspector spoke about this to Mr Matadeen who agreed to offer these changes. The home keeps a record as to who has eaten what. Redholme DS0000012156.V279293.R01.S.doc Version 5.1 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed. EVIDENCE: Redholme DS0000012156.V279293.R01.S.doc Version 5.1 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed EVIDENCE: Redholme DS0000012156.V279293.R01.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 & 30 Standard 29 does not apply as no staff are employed. Mr and Mrs Matadeen ensure that their training is up to date. EVIDENCE: Mr and Mrs Matadeen run the home without any staff. The inspector asked residents if they felt Mr and Mrs Matadeen supported them when necessary, and they said that they could, ‘get help, very regular’ and that it was, ‘an immediate response’. Mrs Matadeen is currently studying for NVQ2. Mr and Mrs Matadeen have completed a certificated Occupational Health and Safety course and a six month Infection Control course, and Mrs Matadeen recently completed a Food Hygiene course. Redholme DS0000012156.V279293.R01.S.doc Version 5.1 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 & 38 Standard 35 does not apply to the home. EVIDENCE: The manager has many years experience in owning and managing Redholme. He has completed the NVQ4 in care, and the Registered Manager’s Award, and is waiting for the certificate. Mr and Mrs Matadeen ensure that they have regular fire safety training and fire drills, often seeking external sources of training. The home’s policy regarding the storage of hazardous cleaning fluids states that they must be locked away, but this has not happened in practice. Fluids are stored in a place where residents would not have cause to access, and residents are not confused. However, there is not a risk assessment in place, and this must be done to identify and minimise any resulting risks. Additionally, the home must undertake an assessment of cleaning fluids used, under the Control of
Redholme DS0000012156.V279293.R01.S.doc Version 5.1 Page 16 Substances Hazardous to Health Regulations 2002. Further advice can be sought from the Environmental Health Officer. Redholme DS0000012156.V279293.R01.S.doc Version 5.1 Page 17 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 N/A 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X N/A X X 2 Redholme DS0000012156.V279293.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? N/A 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 OP38 Regulation 13 (4)(a)(c) Requirement The manager must undertake a risk assessment regarding the storage of hazardous substances, and take action to reduce any risks identified. The manager must ensure there are COSHH assessments in place for hazardous substances. Timescale for action 31/03/06 2 OP38 13 (4)(a)(c) 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Redholme DS0000012156.V279293.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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