Inspection on 14/05/07 for Redlands Residential Care Home

This inspection was carried out on 14th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Residential Care Home 13/05/09

Redlands Residential Care Home 08/02/06

Redlands Residential Care Home 29/06/05

Redlands Residential Care Home 17/12/04

Redlands Residential Care Home 30/06/04

Redlands Residential Care Home 25/11/03

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Redlands Residential Care Home 122 Woodlands Road Darlington Co Durham DL3 9LP Lead Inspector Jean Pegg Key Unannounced Inspection 14th May 2007 09:30 Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redlands Residential Care Home Address 122 Woodlands Road Darlington Co Durham DL3 9LP 01325 243788 01325 243799 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) Castlebeck Care (Teesdale) Limited Mrs Jean Murphy Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2006 Brief Description of the Service: Redlands is a large detached house situated in a residential area of Darlington. The home is registered as a care home providing personal care to adults between the ages of 18 and 65 with a learning disability. The home is within walking distance of Darlington town centre and Cockerton village. This location enables the people who live there, to access a full range of local facilities. Internally the home provides five single bedrooms each with wash hand basin. Shared toilet and bathing facilities are also provided nearby. Downstairs the home has two lounge areas, kitchen, breakfast room, dining room and laundry. A very good standard of furnishings and fittings has been provided within the home. Externally, the home is surrounded by well kept gardens and pathways. Fees for this home are currently between £1, 019 and £2,500 per week. Please check the current rate of fees with the manager. Additional charges are also made for hairdressing, chiropody, personal items and some outings and leisure pursuits. These charges vary according to personal taste. Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We visited Redlands on the 14th and 16th of May and spent in total nine and half hours on this inspection visit. While we were at the home we talked to all of the people who lived there and some of the staff. Before we visited the home we sent surveys out to all of the people who lived there, their relatives and their care managers. We received all of the surveys back from the people who live there and four of their relatives. We have not received any surveys back from care managers. As well as talking to people and sending out surveys, we looked at lots of documents kept in the home and looked at different parts of the house, both inside and outside. The information we got from this visit and from the surveys we got back will be included in this report. What the service does well: There is information available for people to help them make their minds up abut the home. One person said “ I received a service user guide.” The way this information is presented could be made better by involving the people who live there and asking them for their ideas. Although people are only admitted from other Castlebeck Care Units, very detailed assessments and trial visits take place to help the new person decide if the home is the right place for them. One person said “I was at XXX and I was asked, by Dr. X. I think. I came every Friday for a coffee; I then agreed to come here.” Another person said “I was asked by the manager of my previous home if I would like to move to Redlands then I visited Redlands before saying yes.” Everyone who lives at the home has a care plan and they know what is written in that care plan. There are chances for people to take part in the running of the home, for example during house meetings and interviewing staff. Risk assessments are in place and if someone’s freedom is restricted, then the reason for this is written down and plans are put into place to make sure that the person can take part in the community. This means that they do not miss out on anything. One person said “I have to follow my programme and I need an escort to access community facilities.” And another said “ I have to have escorts if I go out.” Everyone is encouraged to live a life that helps them to do the things that they like to do. Contact with family and friends is encouraged and everyone is given the chance to make decisions about their day-to-day lives as much as possible this includes things like planning menus and holidays and learning new skills. One relative told us “I feel my brother’s personality has been taken into account with regard to the way he is handled and the activities suitably provided for him, it would be difficult for me to comment on the needs of the other people and if their needs are being met, but they seem happy and friendly.” Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 6 People have their individual personal and health care needs met by the staff who work at the home. They are also able to visit other health care professionals in the community for example doctors and nurses. The medication that is kept in the home is managed in a safe way. Concerns are listened to and complaints are responded to appropriately. The home also has policies, procedures and training in place to make sure that staff have information available to them to help them respond to suspicions of abuse properly. Redlands is a very clean, comfortable and safe place for people to live in. People are cared for by a team of staff who are well trained and who are professional in their attitude. The manager of the home is very experienced and has qualifications in nursing and management. She has shown that she manages the home quite well. The home has quality assurance systems in place that help to make sure that things are done properly. Health and safety in the home is managed quite well with all the proper checks being carried out. What has improved since the last inspection? What they could do better: The people who live in the home should be more involved in writing the Service Users’ Guide. This guide should be written in an easy read format for people who may have problems with reading or English as a first language. Care staff should be more involved in the pre admission assessment process that takes place before new people are admitted into the home. Their knowledge of the home and the people who live and work there would be helpful in deciding if the placement would meet someone’s needs. Person Centred Plans should have more in them and be about what the individual person wants to achieve in life and what they need to do to be successful. Opportunities to take part in the running of the home could be made better, for example involving those who live at the home in reviewing information about the home as stated earlier. Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 7 Due to the number of staff who have left the home recently the size of the team has got smaller and needs to be made stronger to ensure that standards are maintained. 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 Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 2 & 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available for people to help them make their minds up abut the home. The format of this information could be made better by involving the people who live there. Although the policy of admission is “from within”, detailed assessments and trial visits are followed to help the new person decide if the home is the right place for them. EVIDENCE: The Service User’s Guide and Statement of Purpose are to be updated to show the details of the newly appointed Responsible Individual. The Statement of Purpose tries to reflect the companies approach to equality and diversity by including statements like “Service users are consulted on admission about their religious beliefs to assist them to carry out religious pursuits.” There is also a section on how Civil Rights are to be retained and protected for people who are in receipt of a service. The Service Users’ Guide contains all information that is recommended by the national minimum standards. The manager confirmed that it is due for review in June 2007. It was recommend to the manager that the people who live at the home should be involved in the review and that it should be produced in a Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 10 more imaginative and easy read format for people. When we asked people “Did you receive enough information about this home before you moved in so you could decide if it was the right place for you?” all five said yes, one also explained this by saying “ I received a service user guide.” New people coming into the home are only admitted from other Castlebeck Care Units. The Policy on admission being “from within” The manager described the assessment process that takes place using examples from the people who live there. The manager confirmed that assessment involved a full multi disciplinary team that were mainly Castlebeck employees except for the person’s care manager. The manager describes how she visits potential new people to seek their views and opinions about moving into Redlands. The manager also described how admissions can be delayed until staff receive training in specialist areas that are needed to support the new person. For example training staff in the use of an Epipen or clear protocols agreed with other health professionals to help deal with emergency situations. The admission process also involves two-way visits for tea. These visits help the person to decide if they like the home and also gives those already living in the home a chance to meet the new person. When we asked people “Were you asked if you wanted to move to this home?” All five said Yes. One person said “I was at XXX and I was asked, by Dr. X. I think. I came every Friday for a coffee; I then agreed to come here. I’m not forced to do anything I don’t want to.” Another person said “I was asked by the manager of my previous home if I would like to move to Redlands then I visited Redlands before saying yes.” When staff were asked about the process for assessing people before they move into the home, they said the medical officer and management of the units and social workers were involved. When asked if staff had access to those assessments they said that they had access to the files. We looked at one assessment in detail. The assessments covered a variety of different areas including physical, ethnicity, and ecological analysis including personal aspirations. People are also offered access to an advocate and there is also an assessment of the person’s capacity to give consent. The assessments are quite detailed and form the basis of the individual care plan. Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7&9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live at the home have care plans and they know what is written in their care plans. The person centred plans that are developed could be much better by focussing on people’s individual aspirations of where they want to be and what they want to do in the future. Opportunities to participate in the running of the home are made available but could be further improved for example in reviewing information about the home as stated earlier. Risk assessments are in place and any restrictions of freedom are documented and strategies put into place to enable the person to participate in the community without discrimination. EVIDENCE: We looked at one care plan in detail. It was clear that the plan was based on the assessments that had been carried out and included social as well as physical and emotional needs. Areas of risks had been identified and strategies Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 12 put into place to deal with them. Cultural and ethnic needs are considered however, the file looked at stated that the person had indicated ‘No preference’ as a response. When we asked relatives if they felt that the care home or agency met the needs of their friend or relative, all four said “always” and said things like “ I feel confident that my brothers needs are at the forefront of staff decisions. He is happy and I see improvements each time I visit.” One person spoken to did not know what a care plan was and another was kind enough to talk us through his person centred plan and life history file. We discussed with the manager how we felt that the ‘person centred plan’ could be improved. Staff were able to say who they were the key worker for and describe what their role was. “I look after X generally, I keep his file up to date, his general appearance, his Person Centred Plan and take him to football matches.” Staff also described how they reviewed the care plan each month and described the persons’ involvement in that process “X is involved in planning the next months plan, for example what he would like to do, any issues or problems he may have.” Staff were also able to confirm that the manager monitors the standard of care plans. The people who live at the home are also involved in their annual reviews that take place with their care managers. The people who live at the home and staff who work there told us about ‘house meetings’ that are held each week. These meetings are used to discuss common issues including menus for the following week, where everyone would like to go on outings and other house issues. Records of these meetings are kept. When asked “Do you make decisions about what you do each day?” four people said sometimes and one said always. We also asked “Can you do what you want to do?” three people said yes for during the day, four people said they could do what they wanted in the evening and five people said they could do what they wanted on a weekend. For some of those who said no, they explained that part of their care plan meant that they needed an escort for whatever reason. One person who said no said that this was because “I have to follow my programme and I need an escort to access community facilities.” And another said “ I have to have escorts if I go out.” Other things people told us included “I help plan activities. I can spend free time in my bedroom or lounges.” Some of the people in the home look after their own money with a little bit of help from staff, others do not look after their own money and rely on the staff to keep it safe for them. We were also shown evidence of completed satisfaction questionnaires that the people living at the home had completed. The manager showed us copies of the checklists that the people living at the home help to fill in when new staff are being recruited to work there. As we stated earlier, each person’s care plan has risk assessments in place according to that person’s needs. These risk assessments describe what the risks are to that person and what actions should be taken to keep that person safe. As stated in the previous section this might include having staff to escort them whilst out in the community. This does not mean that they are unable to Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 13 go out in the community as the people who live there gave us lots of examples of how the community is used as part of their leisure and social activities. Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People are encouraged to live a lifestyle that reflects their preferences and is acceptable to them. Relationships are supported and decision-making is encouraged as much as possible. EVIDENCE: From talking to the people who live and work there and by looking at the records kept, it is clear that the people living at the home are helped to develop social, emotional, communication and independent living skills. For example, the people living at the home have friends that they socialise with at the local social club and public house, some attend the local technical college to further their literacy and numeracy skills and some attend football matches so that they can continue to support their favourite clubs. Those who are able to take on additional responsibilities for house hold chores and gardening do Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 15 so. The opportunity to attend church is offered, however, no one living at the house has taken up this offer. When we asked relatives if they thought that the service met the different needs of their relative, three said ‘always’ and one said ‘usually.’ Some also gave us comments like “I feel my brother’s personality has been taken into account with regard to the way he is handled and the activities suitably provided for him, it would be difficult for me to comment on the needs of the other people and if their needs are being met, but they seem happy and friendly.” We also asked the question ‘Does the care service support people to live the life they choose?’ again three said always and one said usually. One relative added “I feel the staff give the best support they can. Sometimes circumstances of the people they are caring for mean that compromises have to be made. For example: my brother would love to see his football team play at every home match, but given the travelling distances involved, he understands that only a number of trips can be made.” The people living at the home are also active members of a local conservation project, which was developed by Castlebeck Care in partnership with Business in the Community and the local Ranger for the Reserve. They spend time with staff and other volunteers working at the Maidendale Nature reserve that involves reclaiming land for the benefit of wildlife and the general public. During lunch we talked about their hobbies e.g., three people who are enthusiastic about football, one person is a talented gardener and keen bike rider. This person has recently acquired an old bicycle, which he is planning to renovate. Another person is enthusiastic about trains. We also talked about the plans that they were making about their forthcoming holidays and they told us stories about the fun they had had on their holidays last year. Some people also told us about the visits they make to their relatives and how their relatives also come and visit them. One person told us “I’ve got two sisters. My oldest sister comes every month. My younger sister works, she’s been up here twice.” Someone else told us how his mother stays at the Guest House, which is just over the road, when she visits. When we asked relatives about being able to keep in touch, they all said that this happened adding things like “ My brother is encouraged to phone me once or twice a week, which is pleasant for both of us. He has on occasion sent me a letter.” None of the people living at the home admitted to having girlfriends although they did talk about different girls that they knew and their positive and negative traits! Health promotion sessions are available to everyone and these sessions provide information about sexual health. Everyone has a bedroom door key and staff ask permission before entering people’s rooms. Staff are also made aware of the name that people like to use or be known by. When we asked staff about respect, privacy and dignity in the home one person said, “We all have good communication skills. We have a Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 16 good working relationship between us.” This was seen to be the case when we were in the company of both the people who live and work at the home. We enjoyed a pleasant lunch during our visit, the food was good, the environment was pleasant and the company friendly and relaxed. We were told that each person plans a day for the menu and that this is decided at the house meeting. For lunch we had assorted sandwiches, boiled eggs, tomatoes, a selection of pickles, crisps and tea or coffee. Most meals are taken in the main dining room that overlooks the back garden. The table is a large square table that can accommodate everyone comfortably. The atmosphere during lunch was very relaxed and jovial. Everyone had something to say and there was lots of banter between everyone. Healthy eating is encouraged but not forced on people. One person has elected to go on a diet and is writing down what he eats each day to take to the GP Surgery where he goes to get weighed. He has been successful in loosing weight. The meal was not rushed. Throughout our visit, one person in particular made sure that we did not go too long without the offer of a drink. Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have their individual personal and health care needs met by the staff who work at the home or other health care professionals who can be accessed in the community. Medication is managed safely in the home. EVIDENCE: The care plans that we looked at took into account everyone’s individual strengths and needs. This dictated the amount of support and help they received in their personal care. Most people were seen to be independent and in need of only occasional prompts and gentle reminders. As we said earlier, people are helped and encouraged to manage their weight and generally look after their health. There is a list of health professional contacts on file and detailed medical notes for each person are kept. The visitors’ book shows that GP’s and the chiropodist have both visited recently. If someone has an allergy then this is identified in their individual files and Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 18 additional training has been provided for staff to help them deal appropriately with some specialist conditions. When we looked at care plans we found that there was evidence that people had given their consent to receiving medication. One person told us “I have eye drops but at night I have my blood pressure taken to make sure I’m all right.” Another person was able to tell us what medication he was on and what it was all for. The manager told us that all staff have been trained in the Safe Handling of Medication and this training is refreshed each year. The staff we spoke to confirmed this. We also saw evidence of the weekly audits that are completed on medicines held in the home. We completed an audit on medicines while we were there. Everything was as it should be. Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Concerns are listened to and complaints are responded to appropriately. The home also has policies, procedures and training in place to make sure that staff have information available to them to help them respond to suspicions of abuse properly. EVIDENCE: We looked at the complaints records held in the home. There have been five complaints made in the last two years by the people who live at the home. Another book showed other complaints that had been made including some made by a neighbour. In all cases, the actions taken to try and remedy the complaint have been recorded. The manager has managed some of the complaints and the company’s human resource department has managed others. The manager told us that general concerns are usually discussed during the weekly house meeting. When we asked relatives if they thought that the home responded appropriately to concerns raised all four said that they did. One said “I feel my brother can voice concerns wither to me or the staff caring for him and that they would be addressed.” And “Although I’ve ticked always, I haven’t actually raised any concerns during my brother’s stay. But I am sure they would respond in an appropriate manner.” When we asked the people who live there if they knew who to speak to if they were not happy, all five said yes. Some named the people they would talk to and one said “Staff, sister and social worker.” From what the people at the home told us we know that the manager listens to all concerns raised. Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 20 No Protection of Vulnerable Adult (POVA) referrals have been made since the home opened. Training in the protection of vulnerable adults is offered to staff and is also covered as part of the learning Disability Award Framework (LDAF) training and National Vocational Qualification (NVQ) training and Root Cause Analysis training. The home also has policies and procedures in place to help staff respond appropriately to any suspicion of abuse. Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Redlands home offers the people who live there a very clean, comfortable and safe environment to live in. EVIDENCE: The home continues to be well maintained both inside and out. A new patio area has been laid and some new furniture has been bought for the lounge. A new shower has also been installed. The manager told us that there are plans to redecorate two of the bedrooms this year. We asked the people who live at the home if the home was fresh and clean. All five said yes. We were told that the home is advertising for a new cleaner since the last one left but until one is appointed everyone in the home helps out to keep it clean. We looked at all of the rooms downstairs and got permission from someone to look in their room upstairs. We could find no reason to be concerned about the standard of cleanliness in the home. Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are cared for by a team of well trained staff who are professional in their attitude. However, due to the number of staff who have left the home recently, the size of the team has been reduced and needs to be strengthened to ensure that standards are maintained. EVIDENCE: We noticed how well the people who work and live at the home communicate with each other and show each other respect. We were told about how staff are given additional training if it is needed to help them meet the specialist needs of the people who live there. At present 77 of staff have achieved at least a National Vocational Qualification (NVQ) in Care at level two. The staff team working at the home is quite small due to people having left the home to work elsewhere. There are also some staff who are off sick. This means that the staff who are left are working extra hours to cover or bank staff are being used. There is some evidence that this shortage is starting to impact on the ability of staff to maintain records to the usual high standard. Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 23 The home is trying to recruit more suitable staff to try and improve this situation. The home does employ both male and female staff to ensure a gender mix for the people who live there. The manager explained about the problems they were experiencing in recruiting staff to the vacancies in the home. Previous inspections have shown that the home follows good recruitment practices and there was no evidence to suggest that this had changed. The manager also told us about how the people who live at the home are involved in the recruitment process. We were shown a copy of the checklist that they use and fill in. This checklist is then used as part of the recruitment decision making process. The manager explained that they were trying to recruit and the visitors’ book showed that people are turning up for interviews. There was a notice in the office that showed that the organisation, Castlebeck Care, offers sponsorship to care staff to complete their nurse training. This means that if they qualify they can then work in other more specialist parts of the Castlebeck Care organisation. The manager completes a training needs analysis each year and this is then forwarded on to the central training team. Staff training is then organised centrally. We were shown the staff training files that record what training each person has been on. When we asked staff if they thought that they were well trained to do their jobs we were told “Yes. I have done computer based learning, health and safety, food hygiene and I have just done the MAYBO course.” There was some evidence of staff supervision sessions taking place. There was evidence that staff have regular contact with the manager and that they think they would be listened to. The manager told us that she aims to achieve six supervisions plus an appraisal each year for each staff member. This standard is in accordance with the unit objectives. Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager of the home is both experienced and qualified and has shown that she manages the home quite well. The home has quality assurance systems in place that help make sure that standards are maintained. Health and Safety is managed quite well in the home. EVIDENCE: The manager has been in charge of the home since it opened in 1999. She is a qualified nurse and has completed the registered managers award. She told us that she is a member of the clinical governance team within the Castlebeck Care group. This team discuss issues concerning best practice, procedures, incidents, etc and makes recommendation for company wide improvements Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 25 and changes to practice. She also attends the company quality assurance meetings. We were given a copy of the most recent service user survey results. These results were from the survey completed in July 2006. The results show that the positive comments made outweigh the negative comments. Periodic Service Reviews (PSRs) are completed on a variety of areas in the home including the environment and care plans. These reviews show how well the home is achieving standards set. Some audits carried out on care plans were seen. Any areas of non-compliance are noted and the key worker is asked to put them right. Objectives for the unit have been written that focus on both the people who live there and the people who work there. The deputy manager completes monthly safety checks and the analysis of accidents and incidents within the home. We were shown copies of maintenance certificates and evidence of recent Potable Appliance Testing. The required checks on fire extinguishers were also up to date. Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 4 14 4 15 4 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 4 x 4 X 4 X X 3 X Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No 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. 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 4 5 Refer to Standard YA1 YA1 YA2 YA6 YA33 Good Practice Recommendations The people who live in the home should be involved in the review of the Service Users’ Guide. The Service Users’ Guide should be written in an easy read format that takes into account different sensory, cognitive and communication needs and abilities. Care staff should be more involved in the pre admission assessment process that takes place. Person Centred Plans should be more detailed and focus on the individual aspirations of the person involved, and what they need to do to achieve them. Recruitment should continue until there are sufficient staff employed at the home to ensure that standards are maintained. Redlands Residential Care Home DS0000000818.V339831.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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. 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