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Inspection on 04/11/05 for Redhouse Nursing Home

Also see our care home review for Redhouse Nursing Home for more information

This inspection was carried out on 4th November 2005.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides good sources of information for service users and potential users and fully supports this with a commitment to good communications and an open and accessible management approach. Care planning and delivery is holistic in approach involving service users and there is a commitment to staff development and training to assist in the delivery of care. Staff supervision is well established and practical in its content. The staff group is very stable and enjoy their involvement in providing a good range of in-house activities, many staff having been employed for many years. There is a commitment to training staff and young people being a placement area for Age Concern training.

What has improved since the last inspection?

The previous requirements and recommendations made at the last inspection have all but one been addressed and completed in good time, the outstanding requirement having been delayed by the slow response of companies requested to quote. The home continues to action its programme of redecoration and refurbishment with further new carpets laid and others on order. The implementation of regular reviews of the assessments is a positive development as is the introduction of the falls related assessment and planning. The cessation of re-sheathing of used hypodermic needles by nursing staff is an important improvement in meeting safety requirements for staff. The provision of mixing valves to ensure a safe supply of hot running water is provided at all staff hand wash outlets at all times has been beneficial in ensuring good infection control practices.

What the care home could do better:

The home would better ensure variety of meals provided by formalising the high tea and supper menu`s. The kitchen windows and external door should be fitted with fly screens enabling these to be opened during hot weather. The home should make available the results of the surveys of satisfaction and any action plan derived from the findings.

CARE HOMES FOR OLDER PEOPLE Redhouse Nursing Home 55 Redhouse Street Walsall West Midlands WS1 4BQ Lead Inspector Richard Eaves Announced Inspection 4th November 2005 09:30 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 Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 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. Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Redhouse Nursing Home Address 55 Redhouse Street Walsall West Midlands WS1 4BQ 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) 01922 616364 01922 616364 Mr Sukhdev Singh Sidhu Mrs Wendy Marie Morgan Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home can admit frail residents requiring nursing care over the age of 50 years. 11th July 2005 Date of last inspection Brief Description of the Service: Redhouse Nursing Home is a small, friendly and homely service, providing a service to the immediate community for older persons of the area and employing staff also from the local population. The home is situated close to local amenities and is conveniently served by public transport. The Home has a clear philosophy, aims and objectives and these are included in the statement of purpose, which provides a comprehensive document, which is available to prospective and current service users. The current mission statement identifies a commitment to staff training and updating. The Home provides in-house catering and laundry services and all grades of staff are encouraged to relate on a personal level to the service users, enhancing the feeling of homeliness. Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection visit was undertaken by an Inspector from the Commission for Social Care Inspection using the following information: the action plan submitted by the home to the unannounced inspection during July 2005, reports from the organisation relating to the conduct of the home, the pre-inspection questionnaire, comment card responses from service users and relatives and records held at the home. The inspection involved a full tour of the property including, bedrooms, communal rooms and service areas and provided an opportunity to speak with most of the service users. Comment cards were received from 5 service users and 3 relatives/visitors to the home. Service user comment card responses all expressed satisfaction with the care and support that they receive. 1 relative expressed a view that there were not always sufficient staff on duty. What the service does well: What has improved since the last inspection? The previous requirements and recommendations made at the last inspection have all but one been addressed and completed in good time, the outstanding requirement having been delayed by the slow response of companies requested to quote. The home continues to action its programme of redecoration and refurbishment with further new carpets laid and others on order. The implementation of regular reviews of the assessments is a positive development as is the introduction of the falls related assessment and Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 Page 6 planning. The cessation of re-sheathing of used hypodermic needles by nursing staff is an important improvement in meeting safety requirements for staff. The provision of mixing valves to ensure a safe supply of hot running water is provided at all staff hand wash outlets at all times has been beneficial in ensuring good infection control practices. 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. Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 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 Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 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): 1-5 Service users and prospective clients including intermediate care users and their supporters are provide with good sources of information about the home and are invited to spend time at the home prior to admission to enable them to make an informed decision about entering the home this is confirmed at admission by contract. The staff group are stable well established and collectively have the knowledge and skills to assess needs and to meet these assessed needs of the current service users. Confirmation that assessed needs can be met furthers enables service users to make informed decision about entering the home as does the opportunity to visit and trial the services offered. EVIDENCE: The Statement of Purpose and Service Users Guide have been reviewed and modified to include details of the new room since completion of the registration process. Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 Page 9 Service users are admitted on the basis of assessments undertaken by qualified nursing staff using a document that covers a wide range of personal details and physical needs and preferences. This document is supplemented in most cases by a care management assessment and further developed on admission by an in-depth, activities of daily living assessment and a range of individual risk assessments. Documented evidence of service user or their representative involvement was seen. In the previous inspection of a random sample of case files it was observed that some admission details were incomplete explained as a decision made to delay until a later time and reviews of assessments were restricted to risk assessments and those with known needs and care plans, this has now been addressed and assessments are all subject to regular review. A letter is given prior to admission confirming that assessed needs can be met by the Nurse led team that have a particular specialist interest in the care of the elderly frail with nursing requirements. The letter invites prospective service users to visit and experience time at the home. A contract is provided giving terms and conditions of occupancy at the time of admission. The home does not provide an intermediate care service. Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 - 11 Care planning at the home is good, clear and consistent, providing staff with the necessary directions of actions required, to ensure that service users care needs are fully met and health is promoted. Arrangements for the administration of medication are good and ensure service users medication needs will be safely met. Service users are treated with respect and their privacy upheld. Staff have been developed to provide care at the time of service users dying with sensitivity and respect. Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 Page 11 EVIDENCE: A random selection of case files were inspected and used for case tracking, these comprise of a consistent format and contain a range of assessments including those for activities of daily living and since the previous inspection a risk assessment specific for falls. Other risks assessed include, pressure areas, continence, nutrition, moving and handling and use of bed rails. Other individual assessments include such Items as personal smoking and going out alone. Assessed needs identified, generated care plans, which detail the actions required by care staff to meet needs and minimise risks and included contingency planning for conditions such as diabetes mellitus and epilepsy. Care plans are subject to at least monthly review and more frequently if short term or subject to continuing change, such as wound care. Service users healthcare is fully met maximising as far as practical the service users own capacity for self care. Each has a GP and other allied medical support is obtained as required, chiropody is provided both through the NHS and privately, routine foot-care is provided by experienced in-house staff. The Home has a good supply of equipment for the promotion of tissue viability and prevention of pressure sores. Each case file showed that the service user or other family member were involved in the development of the plan. The Home has a policy and procedure for dealing with medicines and these are robust and observed to be implemented by staff in all aspects of medicines management. At the time of the inspection no service users were selfmedicating. Arrangements have been made to implement the new regulations for the disposal of waste medications. Medicines are provided on a 28-day cycle by a pharmacy service that also monitors and advises the Home on medicines policy and practice. During the previous inspection it was observed that the medicines room temperature was at 25 degrees centigrade and it was required the home monitor and take action to ensure that 25 degrees is not exceeded. Monitoring identified that the limit was not acceded over the summer and the risk has for the moment receded. The induction programme includes a section on treating service users with respect and their privacy is upheld with locks fitted to bedroom doors, in addition staff were observed to knock before entering and interact in a friendly and open way using the service users choice of name. The home provides end of life care and any palliative needs are met in conjunction with the McMillan Nursing Service. The lead nurse gives bereavement and counselling training at the home. Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 Page 12 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 – 15 The home provides well-organised and varied social and recreational activities that provide interest and pleasure for the residents. Visitors are welcome and help to keep service users informed about the wider community Many aspects of care evidences that service users exercise choice and control over their lives. The meals at Redhouse Nursing Home are good, offering both choice and variety and catering well for special dietary needs. Adjustments to the way the menu is promoted would improve the ability of service users to better make choices of which meals best meet their personal needs, likes and wishes. Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 Page 13 EVIDENCE: An activities calendar is provided and regular in-house events include aerobics, bingo, natural therapies, parties and garden events over the summer. During the year the range of leisure activities in the Home has been extended and now include very popularly Karaoke and arts and crafts work, which again is well received. A number of service users have been registered with ring and ride and use the facility for shopping trips. Visiting clergy provide regular communion for a number of service users. The home has open visiting and a number of family members were observed to visit across the day. The inspection of case files show these to include a section that identifies personal likes and wishes such as rising and settling time and their ability to make their own choices of clothes to wear. In conversation with service users and in responses from the comment cards they feel that these wishes are fully taken into account by care staff in the assistance they provide. The homes policies provide for service users to bring personal possessions including furniture into the home with them and this was observed to be the case with many rooms being personalised with pictures, photographs, ornaments and some with items of their own furniture such as chairs and display cases. The assessment process clearly identifies to service users that they may access their case file at any time and this is reiterated during reviews. The 4-week rotating menu provides for a nutritious diet and choice, take up by individual service users is monitored and recorded. Cooked options are available at breakfast, lunch and high tea and snacks are available at all times. Special diets, religious and cultural dietary needs are catered for. Cakes are provided for birthdays and other special occasions. While supper is available neither the service user guide or menu make reference to it, the availability of snacks are noted, details of this provision would be helpful to service users as would a formalisation of the high tea menu. Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 –18 The home complaints and protection policies are robust providing a safe environment in which service users feel they can voice concerns and that these will be listened and responded to. Service users rights are protected and staff demonstrate excellent knowledge and understanding of adult protection issues that contributes in providing an environment safe from abuse. EVIDENCE: The complaints procedure is readily accessible to service users and their supporters with reference in the contract, the statement of purpose and is on display on the notice board. One complaint has been received since the previous inspection resulting in disciplinary action. The electoral roll has recently been completed and a number of service users have received confirmation that they will be able to make a postal vote in forthcoming elections. The home has robust procedures for responding to any suggestion of abuse and in-house training is given in adult protection procedures. Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 – 26 The home provides a good standard of décor, furnishings and managed services providing a safe, disabled accessible environment and an attractive, and homely place to live. The bedrooms have bathrooms in close proximity for the convenience of service users. The home is clean, free from odours and hygienic. EVIDENCE: A tour of the building found the home to be clean, hygienic and free from offensive odours. Decoration is in good order with some having been undertaken recently, the bedrooms and communal areas are comfortably furnished to provide a homely environment. Records are kept which detail routine maintenance and redecoration, the records of monitoring services such as fire, emergency lighting and water temperatures were up to date and show any actions taken if adjustments have been required. Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 Page 16 Since the previous inspection a number of rooms have been re-carpeted with further orders made to continue the replacements. Hot water monitoring records have been modified to document the adjustments made to ensure a safe supply. The laundry is well equipped with washers that meet the requirements for sluicing and disinfection of linen. A sluice disinfector is provided for cleansing of toileting items such as bedpans and urinals. Staff hand wash facilities have controlled hot water that promotes good hand washing practice. Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 Page 17 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 – 30 The home has a good mix of staff in sufficient numbers to provide consistency of care that meets service users needs. The home has been proactive in developing a skilled staff group with understanding of service users needs. Recruitment and selection processes are to a good standard protecting vulnerable people. EVIDENCE: The rotas confirm that numbers across the 24hour period and skill mix of qualified and unqualified staff are appropriate to the needs of service users. The ancillary services provide a full 7-day service. The home continues to be used for the placement of trainees provided by Age Concern. The standard of 50 of care staff being trained to NVQ level 2 standard has been exceeded and continues to be increased. All staff have an individual training record and a training matrix of mandatory and other regular training required. Recruitment and selection are completed to a good standard and includes all necessary checks such as CRB, POVA and nursing registration. Staff files also show that two references are obtained and a record kept of the interview. Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35, 36 & 37 The home regularly seeks the views of service users and relatives to assess its performance in meeting their needs. The sound financial management of the home and arrangements for safekeeping of their money safeguards service users interests personal and financial. Leadership is good at the home with supervision and direction to staff to ensure that the service users receive consistent quality care this should be further demonstrated by documented involvement of the proprietor. Records maintained by the home support the delivery of care and services that ensure consistency and safety for service users. Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 Page 19 EVIDENCE: The home undertook a survey of service users satisfaction and separately a survey of relatives early in the year and have embarked on a second survey. The responses of the early survey were positive and supportive of the home. The proprietor is appointee for one longstanding service user otherwise only assistance is given to ensure safekeeping of personal allowances, these are subject to records kept of income and outgoings including receipts of purchases made on service users behalf. Staff supervision is well established and applied in a relevant process that covers all aspects of practice. Records required by regulation and the schedules are maintained and kept up to date. Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 3 3 X Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 Page 21 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 OP19 Regulation 16(2)(g) Requirement The responsible person must fit fly screening to the kitchen window and external door. Timescale 31/8/05 not met. The registered person must ensure that meals are varied by formalising the high tea and supper menu’s. Timescale for action 31/12/05 2. OP15 16(2)(i) 31/12/05 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 OP33 Good Practice Recommendations The registered person should make the findings of the survey currently ongoing and any action plan arising available to the Commission. Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Redhouse Nursing Home DS0000020793.V252990.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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