CARE HOMES FOR OLDER PEOPLE
Redlands House 134 Reepham Road Hellesdon Norwich NR6 5PB Lead Inspector
Ann Catterick Unannounced 21 July 2005, 09:30.
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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 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. Redlands House I55 s60855 Redlands House v238605 (un) 210705(4).doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Redlands House Address 134 Reepham Road Hellesdon Norwich Norfolk NR6 5PB 01603 427337 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Rhoderick Smart and Mrs Frances Smart Miss Lisa Rutter Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Redlands House I55 s60855 Redlands House v238605 (un) 210705(4).doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Thirty-three (33) Older People, not falling within any other category may be accommodated. Date of last inspection 03 March 2005 Brief Description of the Service: Redlands is a care home providing personal care and accommodation for 33 older people. It has recently changed ownership and is now owned by Mr Rhoderick Smart and Mrs Frances Smart and the new registered manager is Lisa Rutter. The home is located on a busy road in Hellesdon on the outskirts of Norwich. It is close to all local amenities. Redlands is a large detached house that has been much extended over recent years. There is accommodation on the ground and first floor, providing seven double and nineteen single bedrooms. Some of the rooms have en-suite facilities and there are a number of other toilet facilities throughout the home. There are three bathrooms and one shower room. There are three communal lounges and a large dining area. There is a passenger lift. The grounds and garden area are well maintained and provide attractive outside facilities for service users in the summer months. Redlands House I55 s60855 Redlands House v238605 (un) 210705(4).doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place on the 21st of July. The inspector was able to speak with service users, the manager, staff and visitors as well as look at documents, plans of care and tour part of the building. Several service users were spoken to and most spoke very favourably about the home. Some service users who have lived in the home for some time still miss the previous manager and owners but are readjusting to the new management structure. Those visitors spoken to were very positive and had only praise for the home. Staff spoken to were seen as caring and competent and the overall quality of care provided within the home is good. What the service does well:
Some time was spent in the lounge talking to different service users and some service users were spoken to within their own rooms. All spoke positively about the care they received. One service user said, “If they grumble about here they would grumble about heaven.” Others said, “Staff are kind and care for us very well.” The quality of the food is good and lots of positive comments were made by service users about the food. The inspector was in the home at lunchtime and this looked appetising and well presented. Those visitors spoken to said that they were always made welcome and that the home was always clean and tidy. Relatives spoke of the good quality of care received by their relatives. Those staff spoken to had received training and had both recently commenced their NVQ level 2. The new manager is promoting activities. Overall the manager and staff are aiming to provide good quality care to those people who live in the home. Redlands House I55 s60855 Redlands House v238605 (un) 210705(4).doc Version 1.40 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.
Redlands House I55 s60855 Redlands House v238605 (un) 210705(4).doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Redlands House I55 s60855 Redlands House v238605 (un) 210705(4).doc Version 1.40 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 standard(s) 3 and 6 Prior to admission a prospective service user’s needs would be assessed to ensure that the persons identified needs could be met within the home. Intermediate care is not provided within this home. EVIDENCE: Some care plans were inspected and assessments prior to admission were seen on file. The home would seek an assessment from the relevant professionals as well as complete their own assessment. The home does not provide intermediate care. Redlands House I55 s60855 Redlands House v238605 (un) 210705(4).doc Version 1.40 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 standard(s) 7 and 10 Care plans are in place but there is the opportunity for further development in this area. Service users are treated with respect by staff and their privacy and dignity are upheld. EVIDENCE: Several care plans were seen on the day of inspection and the information in them was rather limited. The manager has plans to revise the care plans and make them much more comprehensive with as much relevant information in as possible to ensure that service users are cared for in the most appropriate way for their specific needs. Several service users were spoken to and they all spoke very favourably about staff saying that staff worked in a caring and professional way respecting their dignity and promoting their privacy. This was seen to be the case on the day of inspection. Redlands House I55 s60855 Redlands House v238605 (un) 210705(4).doc Version 1.40 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 standard(s) 12,13 and 15 Overall service users find that the lifestyle experienced matches their expectations and satisfy their social needs. Service users are encouraged to keep contact with family and friends as well as contacts within the wider community. Service users receive a wholesome balanced diet in comfortable surroundings at times that are convenient to them. EVIDENCE: On the day of inspection many service users were spoken to a most felt that their lifestyle experiences in the home were positive. The home has changed ownership in recent months and for some service users, who have lived in the home for some time, they are still in a period of adjustment. The home provides specific allocated hours for activities and the manager is planning to develop this area further. The home has a mini bus and trips out are usually planned once a week. The home has a good quota of staff on duty at most times and there is the opportunity for staff to spend social time with service users.
Redlands House I55 s60855 Redlands House v238605 (un) 210705(4).doc Version 1.40 Page 11 Visitors were spoken to and said that they were always made welcome when visiting the home, feeling free to visit at anytime. Service users spoke of relatives and friends visiting the home on a regular basis. The home provides good quality meals in pleasant surroundings and the meal on the day of inspection appeared to be nutritious and appetising. Some comments about the food were made suggesting possible areas for improvement. This is an area that could be discussed at residents meetings. On the day of inspection staff were heard in the morning asking service users what they wanted for tea that afternoon and what they wanted for dinner the next day. This is not seen as good practice and it is recommended that service users be asked what they want for lunch on the day they are going to eat it. Redlands House I55 s60855 Redlands House v238605 (un) 210705(4).doc Version 1.40 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 standard(s) 18 The home has a policy and procedures for the protection of vulnerable adults and those staff spoken to had sound knowledge in this area. EVIDENCE: The home has a policy for the protection of vulnerable adults and this has been seen on a previous occasion. The two staff spoken to on the day of inspection were fairly new in post and spoke of their induction. They are informed about the policy at this time and were clear on the whistleblowing policy and felt confident on what to do if they had any concerns in this area. Both staff were completing their NVQ level 2. The area of adult abuse is covered in detail as part of the NVQ. Service users all said that staff were very kind and that they were always treated in a kind a caring way. Redlands House I55 s60855 Redlands House v238605 (un) 210705(4).doc Version 1.40 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 standard(s) 19 and 24 Overall service users live in a safe well-maintained environment and the home was clean, tidy and free from offensive odours on the day of inspection. EVIDENCE: The home has changed ownership within recent months and the new proprietor is aiming to develop and improve the service. The overall quality of the environment is good. Not all of the radiators have been covered or are of low surface temperature and a recommendation has been made in this area. On the day of inspection the home was clean and tidy and free from offensive odours. Redlands House I55 s60855 Redlands House v238605 (un) 210705(4).doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The amount of staff working in the home at any one time meets the needs of service users. EVIDENCE: The rota was looked at and on the day of inspection six care staff were on duty, two domestic staff and a cook. During the afternoon five care staff were on duty and one cook. The rota inherited by the new manager had minimal staff on duty between 2pm and 4 pm but this has improved since the last inspection. As new staff are employed the manager will ensure more cover at this time as overall the home has a good mix and quantity of care staff. Those staff on duty were competent and trained to do their work. Redlands House I55 s60855 Redlands House v238605 (un) 210705(4).doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 38 The manager has significant experience in the role of manager and discharges her responsibilities in full. The health and safety of service users is promoted. Redlands House I55 s60855 Redlands House v238605 (un) 210705(4).doc Version 1.40 Page 16 EVIDENCE: The manager is an experienced manager who has her NVQ level 4 in management and care. She has now been in the home several months and establishing herself in role. She is looking to promote good practice and to ensure the home provides good quality care. The policies within the home and the training offered to staff aim to promote the safety and welfare of staff and service users. Those staff spoken to were clear about the fire procedures and had received training in manual handling. Not all of the radiators within the home are covered although they are regulated and a recommendation to ensure these are safe has been made. Staff who work in the kitchen have a food and hygiene certificate and all staff have, or have applied for, first aid training. Redlands House I55 s60855 Redlands House v238605 (un) 210705(4).doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 3 x x x x 3 x x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x 3 x x x x 2 Redlands House I55 s60855 Redlands House v238605 (un) 210705(4).doc Version 1.40 Page 18 NO Are there any outstanding requirements from the last inspection? 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 Regulation Requirement Timescale for action 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 15 38 6 Good Practice Recommendations That service users are asked what they would like for lunch on the day that they are to eat it. That radiators be assessed to ensure that they are covered or are regulated or are of low temperature surfaces. That the manager assess the situation with regard radiators and cover or replace any that would be a risk to service users. Redlands House I55 s60855 Redlands House v238605 (un) 210705(4).doc Version 1.40 Page 19 Commission for Social Care Inspection 3rd Floor - Cavell House St Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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