Inspection on 26/10/06 for Redlands House

This inspection was carried out on 26th October 2006.

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

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

Other inspections for this house

Redlands House 02/04/09

Redlands House 08/04/08

Redlands House 24/04/07

Redlands House 29/11/05

Redlands House 21/07/05

Redlands House 03/03/05

Redlands House 11/10/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Redlands House 134 Reepham Road Hellesdon Norwich Norfolk NR6 5PB Lead Inspector Ann Catterick Unannounced Inspection 26th October 2006 09:15 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 Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 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 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) Redlands@fireflyuk.net Rhoderick James Robert Smart 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 DS0000060855.V318126.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Thirty-three (33) Older People, not falling within any other category may be accommodated. 29th November 2005 Date of last inspection Brief Description of the Service: Redlands House is a care home providing personal care and accommodation for 33 older people. Mr Rhoderick Smart and Mrs Frances Smart own it and the Registered Manager is Lisa Rutter. The home is located on a busy road in Hellesdon on the outskirts of Norwich and is close to all local amenities. Redlands House is a large detached house that has been 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. The range of monthly fees at the time of writing the report is from £340 to £400. Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was a key unannounced inspection and the visit to the home took place on the 26th of October 2006 and lasted 8 hours. Prior to the inspection a pre inspection questionnaire was completed by the manager and returned to the Commission with all relevant details. Ten comment cards were received by service users. Nine relatives of service users returned comment cards. Generally comments received were positive. All relatives said that they were satisfied with the overall care and that they were welcomed at any time and could always visit their loved ones in private. Five relatives said that staffing level were ok and three felt they were not OK and could be improved. Nine out of ten service users said they knew who to make a complaint to. Four felt they always received the support they needed and five felt they usually did. Three felt there were always enough activities, three felt there were usually enough activities and four thought there were sometimes enough activities. Overall the feedback indicated that most service users and relatives are satisfied with the service most of the time and if they were not they new who to speak with. Overall the information received prior to the inspection and the information and evidence observed and inspected on the day of inspection suggested that Redland House is a good service offering good quality care to those who live there. What the service does well: The home does not accept a service user into the home unless assessments are made and identify that the service users needs could be met within the home. The home has improved staffing levels and staff appeared unrushed and happy in their role. Some of the comments received about staff were as follows: Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 Page 6 “The staff are very pleasant and kind and willing. They are very loyal.” “The Redlands team continues to be excellent” “Staff are usually pretty supportive, but at times it is not always possible for the staff to give enough, because of the shortage of staff.” Many of the service users said how they enjoyed having the availability of the mini bus and there weekly trips to the coast or countryside. Most service users were very positive comments about the food. The environment is clean and fresh with ample communal space for service users. Most service users spoke positively about the meals in the home. Some of the comments received about food were as follows: “Usually the food is very satisfactory. Compliments to the chef.” “Acceptable but not outstanding.” “Food is good enough.” “Good food, delicious soup” What has improved since the last inspection? What they could do better: The manager needs to encourage more staff to become qualified up to NVQ level 2 or its equivalent The Proprietor needs to record findings of regular unannounced visits and to make the records of these available to the Commission. Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 Page 7 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. Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 Page 8 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 Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments are made prior to admission and the service users living in the home are having their assessed needs met. The home does not offer intermediate care. EVIDENCE: Three care plans were looked at in detail and all had evidence of assessments being received from placing professionals as well as assessments completed by the manager. One service user had been transferred from another home in the company and their current needs had been assessed as being more appropriate to the care provided at Redlands House. Good assessments were seen on file from nurses, social workers and GP’s. The home has its own assessment form. The home does not provide intermediate care. Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users health and personal care and needs were set out in individual care plans. Service users felt that they were treated with respect and that their privacy was upheld. The care and administration of medication appeared to be sound. EVIDENCE: Those care plans seen were comprehensive and up to date. All care plans have a front page with photograph giving relevant details in case of emergency. All care needs were identified within the plans of care. For example continence needs, nutritional needs and risk assessments were seen in care plans. There was evidence of social histories on files although one of these had been tucked behind other papers and not easily accessible. The home is now asking relatives and friends to help in the collation of a social history. A comment was made about bathing and that this is offered only once a week although the manager said that service users could have more frequent baths if they chose Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 Page 11 to do so. Service users preferences in this area could be identified in care plans. A recommendation has been made in this area. Care plans were being reviewed on a regular basis. Medication practice was observed at lunchtime and two medications were cased tracked. Practice observed was good and records seen were correct. All staff who administer medication have had the appropriate training. Service users felt that they were treated with respect and that there privacy was protected. All interaction between staff and service users was positive and offers of personal care or general assistance was given in an appropriate way that promoted dignity and respect. Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and15 Quality in this outcome area is good. This judgement was made using available evidence including a visit to the service. Activities take place on a regular basis. This area could continue to be developed further as more information is collated with regard specific hobbies and interests of individual service users. Relatives are made welcome in the home. The food provided is wholesome and nutritious being served in a comfortable environment. EVIDENCE: Comment cards offered mix views with regard activities with all stating there were activities with some saying they would like more. The home has a mini bus and service users are taken out to the coast or countryside most weeks. The library visits the home on a regular basis and board games are sometimes played. Service users were seen with knitting and one service user still has her own transport. Service users commented on the summer fete saying this was a grand event. Staff do sit and talk to service users and they need to be encouraged to do this as much as possible. The home has many residents who can express their views and preferences very well and resident meetings Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 Page 13 may be a good way to encourage this. A recommendation has been made in this area. Visitors are encouraged and made welcome within the home. Service users have choice about when they rise and retire, what they have at meal times, were they choose to sit in communal areas and whether or not the choose to stay in their own rooms. Those rooms seen were made very personable by the occupants and included possessions that service users had brought from home. Some comment cards stated that only one member of staff assists at breakfast time and that this was sometimes not enough. One comment was about the quality of the bread saying it was horrible. A comment was made that breakfast trays do not always include all that they should with items of food or condiments forgotten. All other comments about meals and meal times were positive. Menus were seen and offered variety and choice. A hot choice is offered at lunch and dinner. The nutritional needs of service users are noted. The dining area is a comfortable environment to eat. Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All service users spoken to on the day of inspection were aware of what to do if they wished to make a complaint. The home has a policy to safeguard service users and those staff spoken to were aware of this policy. EVIDENCE: The home has a policy and procedure to deal with complaints and all of those service users spoken to were clear on what to do if they wanted to make a complaint. The home has a policy and procedures with regard the safeguarding of vulnerable adults and the manager is aware of the local adult protection procedures. All of those staff spoken to were aware of the whistle blowing policy. The home had received no direct complaints since the last inspection. The CSCI had received a complaint and this had been investigated by the home with the outcome being sent to the CSCI. Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 25 and 26 Quality in this outcome area is good. This judgement was made using available evidence including a visit to the service. A comfortable environment that meets the needs of service users. EVIDENCE: Overall the quality of the environment is good. Private and communal accommodation is comfortable. Double rooms have screens and are only used for service users who are related or chose to share a room. A comment made by a service user was that now the dividing window between the two connecting lounges is left open the TV from one lounge could be heard in the other. This means that there is not a quiet lounge for service users to sit in and read that is TV free. A recommendation has been made in this area. The outside area has garden furniture and is used in the warmer weather. Service users commented on the fete that was held in the grounds in the summer. There are some areas of the home were decoration is looking rather Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 Page 16 tired but the plan for the home is to refurbish in the near future and redecoration and more major improvements will take place at that time. The home was clean and tidy with no offensive odours present. Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement was made using available evidence including a visit to the service. If the amount of staff with NVW level two or its equivalent increases the quality in this outcome area will move to good at the next inspection. EVIDENCE: The home has enough care staff on duty to meet the needs of the service users. At the present time there are several, relatively independent, service users living in the home who need minimal assistance from staff. As more dependent service users are admitted the home will need to review and reassess staffing accordingly. Those staff observed on the day of inspection appeared competent and experienced providing good quality care. The home was clean and tidy and was evidence that the home has sufficient domestic staff. The home does not have sufficient staff with NVQ level 2 or its equivalent. A requirement has been made in this area. Four staff have NVQ level 2 and 4 staff are completing NVQ level 2. The manager needs to encourage staff to complete NVQ training to ensure that at least 50 of staff are trained to this level. The home has a new application form and this is an improvement. Those staff files inspected contained all of the information required and staff had not commenced work until this documentation was received by the home. Training information is at present kept on the individual staff files but the manager aims to develop individual staff training files. The manager has Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 Page 18 recently bought into to a good programme for the new induction standards and new induction books were seen. This was seen as good practice Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement was made using available evidence including a visit to the service. The home is well managed and offers a safe environment for service uses to live in. Some quality assurance takes place but more could be done in this area. Service users finances are protected and formal supervision takes place. EVIDENCE: The manager has the Registered Manager Award and has been in a management position for some years. She is at present the senior Registered Manager within the company. Staff receive regular supervision and this is recorded. The home has started to collate information with regard the quality of the service and is planning to publish the findings. Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 Page 20 Policies were reviewed earlier this year and updated when appropriate. The Proprietor continues not to complete regulation 26 reports and these would be a good tool and evidence in relation to auditing and improving the service. A requirement has been made in this area. The home does not look after any of the service users money. Some residents are responsible for their own money and eight are subject to a Power of Attorney. If the service user needs to purchase something or, for example, have their hair done or pay for a chiropodist the home pays and then invoices the family or Power of Attorney. This system appears to work well. Since the last inspection all radiators have been covered and no longer create any risk to service users. Staff have either completed or are about to complete mandatory training. Dates for updates on fire safety, and moving and handling were seen. Training offered to staff was on the notice board, examples being, challenging behaviour and mental health. Food hygiene training is completed in house. All of those staff who administer medication have had certificated training. The premises are secure. Risk assessments are carried out and all incidents and accidents are recorded. All staff receive induction and foundation training. Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 x x x x 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 3 Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 Page 22 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 OP28 Regulation 18.1(a) Requirement Timescale for action 01/04/07 2 OP33 26 The registered person must ensure that the home has at least 50 of staff who have NVQ level 2 or its equivalent or are training to do so. The registered person must 01/04/07 ensure that regular unannounced visits to the home are made as described in regulation 26.4 and a copy of the report made with regard this visit is available to the Commission. 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 Refer to Standard OP7 OP12 Good Practice Recommendations It would be good practice to record in a service users care plan their preference with regard the number of baths they would prefer each week. It would be good practice to encourage resident meeting to enable service users to express their views and preferences with regard all matters relating to the home. DS0000060855.V318126.R01.S.doc Version 5.2 Page 23 Redlands House 3 OP20 It would be good practice to enable one of the lounges to be television free for those service users who do not like the television or find it distracting. Now the connecting door between two lounges is left open the sound of the TV impinges on the quiet of the quiet lounge. Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Redlands House DS0000060855.V318126.R01.S.doc Version 5.2 Page 25 - 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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