Inspection on 12/01/06 for Redlands Rest Home

This inspection was carried out on 12th January 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 Rest Home 20/12/06

Redlands Rest Home 11/08/05

Redlands Rest Home 13/01/05

Redlands Rest Home 17/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Redlands Rest Home 44/46 Park Road Lytham Lancashire FY8 1PN Lead Inspector Denise Upton Unannounced Inspection 12th January 2006 10:00a 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 Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Redlands Rest Home Address 44/46 Park Road Lytham Lancashire FY8 1PN 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) 01253 725835 Mrs Victoria Islam Mrs Susan Guy Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th August 2005 Brief Description of the Service: Redlands is a care home providing personal care and accommodation for up to 23 older people who do not require nursing care. The registered provider does not live in the area although her appointed representative visits the home on a regular basis. In consequence a registered manager is appointed who undertakes day-to-day management responsibility at Redlands Care Home. The majority of service users currently accommodated are male who have previously lived a transient lifestyle. Staff are responsive to individual needs and requirements with social stimulation and activity determined by the individual and tailored in the main on a one to one basis with a member of staff. Redlands Care Home is situated in a convenient location close to the main shopping area of the Town and local resources and amenities. The home is arranged over three floors and offers individual bedroom accommodation for the majority of service users. Although bedroom accommodation does not provide an en-suite facility, bathing and toilet facilities are sufficient in number, conveniently situated and provided with appropriate aids. As the vast majority of service users smoke it is not a practical option to provide a none smoking area. A passenger lift is provided for ease of access throughout the building. Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a period of just over five hours on a midweek day. The inspector spoke with the registered manager, a further member of the management team and individual discussion also took place a carer who was on duty during the course of the inspection. In addition, several residents living at the home were spoken with either individually or collectively in the lounge and dining room area of the home. A number of records and policies and procedures were also examined and a partial tour of the building took place that included communal areas and kitchen and laundry facilities. The majority of the core standards regarding Care Homes for Older People had been assessed at the last inspection that took place in August 2005. The outstanding nine core standards were assessed at this inspection along with a reassessment of the requirement and recommendations identified at the last inspection. What the service does well: This is a care home where residents are well looked after and staff work hard to provide a high quality service. The staff team work well together, have a good relationship with all the people who live at the home and show a good understanding of the needs and wants and wishes of each individual resident. There is a stable staff group, the majority of which have worked together for a long time and know the residents well. This ensures residents enjoy a continuity of care that helps them feel comfortable and safe. Residents spoken with felt well cared for and stated they were very pleased with the individual care and support received. One resident said that he was ‘very happy with the staff’ who were ‘all very good’ Meals are varied, well balanced and nicely presented offering choice and variety that are based on the known likes and dislikes of residents accommodated. Residents are always very positive in their comments about the food served and the help and care received from the staff group. Daily activities are arranged in response to each individual resident’s wants and wishes. A number of current residents often prefer one to one activity with a member of staff either in the home or local community rather than organised group social activities arranged ‘in-house’ while other residents access local community facilities independently. However some residents also enjoy playing board games or quiz’s with staff in the evenings. Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: There are a number of things that the registered person and registered manager could to do to make sure that people who live at the home are cared for by well qualified staff and live in a well maintained property. The registered manager at Redlands Care Home is very experienced and competent in running a care home for older people but should undertake a specific qualification especially for managers of care homes to make sure the home is run in the best way possible. It is understood that arrangements have been made for the registered manager and two other members of the staff team to commence this course of study in the near future. Although the majority of staff are pleased to undertake short course training covering a variety of topics, most staff are reluctant to undertake a nationally recognised NVQ training course especially designed for care staff. At least 50 of the care staff team should have by now achieved Level 2 of this award and care staff should be encouraged to reconsider their decision and undertake a National Vocational Qualification course in care. Although all staff have undertaken a basic first aid course, it is recommended that a person who has taken an additional, more advanced qualification in first aid should be on duty at all times. The report has also recommended that attention be given to the external window frames and some windowsills of the property to ensure they are maintained to an acceptable standard. Please contact the provider for advice of actions taken in response to this Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 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 Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the above six standards were assessed at this inspection. EVIDENCE: None of the above six standards were assessed at this inspection. Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 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): Standard 7 in part. There is a clear and consistent care planning and review process maintained in the home. The systems adopted provide staff with the information they need to satisfactorily meet service users needs. EVIDENCE: All service users at Redlands Care Home have an individual plan of care that identifies the individual service user’s current strengths, needs, wants and wishes. As recommended in the last inspection report, the outcomes of individual risk assessments are now incorporated in the appropriate care plan. Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 Page 11 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): 12,13,14 & 15 Service users are encouraged to maintain contact with family and friends wherever possible or to develop new friendships while living at the home. The routines of daily living are kept flexible to enable service users to live the lifestyle of their choice. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choice. EVIDENCE: During the course of the inspection it was observed that the routines of daily living and activities remain flexible and varied to meet individually assessed needs. It was noted that service users are enabled to exercise choice in all aspects of their daily life that was also confirmed through discussion with several service users As a result of the previous transient lifestyle of the majority of service users accommodated at Redlands Care Home, contact with relatives and former friends is limited. However service users are encouraged and enabled to maintain or re-establish family or friendship links if they so wish and social relationships are encouraged either through family/friends visiting at a time of the service users choice or social stimulation in the wider community. Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 Page 12 The majority of service users prefer an individual response from staff in addressing their social needs rather than regular group activities ‘in-house’. However, some service users continue to enjoy staff involvement particularly in the evening period, to complete crossword puzzles and playing card games with others preferring to individually undertake social activities of their choice. The relationship between service users and staff is very positive and the staff group are very proactive in addressing the individual service user’s social care needs on a one to one basis. A number of service users also enjoy accessing local community resources and facilities independently. All service users with capacity and who wish to do so are encouraged to remain independent in respect of their own financial affairs. However, a number of service users currently accommodated have elected to receive their personal allowance on a daily basis in order to ensure there are sufficient funds available to last the week. Although it is infrequent that a newly admitted service user will have personal possessions, service users can personalise their bedroom accommodation to reflect their individual wishes and requirements. Meals and mealtimes at Redlands Care Home are given high priority with a varied and balanced menu provided that is designed round the known likes and dislikes of service users living at the home. Specialist diets in respect of religious, cultural or medical need can be accommodated and as observed, hot and cold drinks and snacks are made available throughout the day. As always, service users spoken with were very positive in their comments regarding the quality and variety of the meals served. The menu reflects seasonal changes however service users enjoy the same foods and are generally reluctant to change and are comfortable with the existing menu. However specific meals are provided in response to individual requests. One resident described the meals as ‘very good’ and confirmed he could choose what he wanted to eat and another resident also said that the meals were ‘very good’ and that he always enjoyed the food served. Meal times are relaxed and unhurried and staff discreetly and sensitively offer assistance as and when required. Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 Page 13 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 has a satisfactory complaints system with evidence that service users feel their views are listened to and acted upon. Staff receive training in respect of adult abuse issues that helps protect service users from potential abuse. EVIDENCE: The complaint procedure at Redlands Care Home is fully compliant with requirements and identified in the Statement of Purpose and Service User Guide. However it is recommended that rather than a complaint be recorded in a collective book as at present, in order to ensure confidentially, any complaint received should be recorded on a individual complaint form that identifies the name of the complainant and date the complaint was received, details the complaint, the process of investigation, the outcome, any action taken as a result of the outcome and the date the complainant was informed of the outcome. Service users spoken with stated they were unsure about having read the home’s complaint procedure but were in no doubt that if they had a complaint they would speak with the registered manager ‘straight away’. Service users also felt that if they did make a complaint it would be ‘looked into’. Redlands Care Home has developed a variety of policies and procedures observed at inspection for the protection of service users. These include an Adult Protection Policy based on the `No Secrets In Lancashire` document and Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 Page 14 a whistle blowing policy to protect service users from abuse or discrimination. Policies have also been developed in respect of service users monies, gifts, wills and hospitality and aggression. Any items held for safekeeping are secured in a locked environment with appropriate records kept. Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 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 standard of the internal environment within this home is adequate in providing service user with a comfortable place to live. However attention is required to areas of the external environment of the property to prevent further deterioration. EVIDENCE: Service Users at Redlands Care Home live in a safe environment that is maintained to an acceptable standard. The accommodation is domestic in character and has been designed to meet the individual and collective needs of service users accommodated. The layout of the home gives residents opportunity to move freely round the building and access all areas with ease. The home is maintained and decorated to an acceptable standard however although staff try hard to maintain the physical standards, this can sometimes be impeded by the personal behaviours, habits and life style of some service users accommodated. The home offers alternative lounges and a newly Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 Page 16 decorated and carpeted dining room however it is not a practical option to provide a designated smoking lounge as the vast majority of service users smoke. There is a passenger lift available for ease of access first and second floor bedroom accommodation. It was noted that the external environment of the building, particularly some window frames and windowsills required attention in order to maintain an acceptable standard and to prevent further deterioration. The home was clean, hygienic and free from offensive odours at the time of this inspection. Redlands Care Home has a variety of policies and procedures in place for the control of infection and safe handling of waste products including clinical waste and dealing with spillages. Laundry facilities are situated away from kitchen and dining areas and do not intrude on service users accommodated. All laundry is washed at an appropriate temperature and it is understood that facilities comply with the Water Supply (Water Fittings) Regulations. Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 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 & 28 Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their whole quality of life. However the staff group should consider undertaking nationally recognised NVQ training to supplement the short course training already undertaken. EVIDENCE: Redlands Care Home staffing levels and skills mix are determined in accordance with the assessed needs of service users accommodated. There are additional staff on duty at peak times of activity during the waking day and during the night time period a ‘waking watch’ member of staff is on duty along with a person who is ‘sleeping in’ on the premises. Although one member of staff has designated responsibility for domestic duties along with some care responsibilities, all staff have some responsibility in respect of domestic and catering tasks to ensure domestic and catering standards are maintained. As identified in previous inspection reports, currently only two members of the care staff team have successfully completed a Level 2 National Vocational Qualification (NVQ) in care. Although the management team at Redlands are pro active in encouraging staff to develop their individual skills and abilities and the staff team are willing to undertaken a variety of external short courses, the majority of staff remain reluctant to consider undertaking NVQ training. Whilst it is acknowledged that the majority of the staff group have worked with the service users for a considerable period of time and are aware Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 Page 18 of, and able to address their current wants, strengths and needs, it is never the less recommended that staff are encouraged to reconsider their decision and undertake formal, nationally recognised NVQ training in care to develop and reinforce their existing skills and to ensure service users are cared for by a well qualified staff group. Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 Standards 33 & 38 were inspected in part. The manager provides clear leadership throughout the home. However it is recommended that the manager undertake a nationally recognised care manager’s qualification to ensure she has the required skills and abilities to manage the care home. It is understood that arrangements have now been made in order to fulfil this requirement. EVIDENCE: The registered manager at Redlands Care Home is very competent and experienced to run the care home and has undertaken periodic training to expand and update existing skills and knowledge. However there is a requirement that the registered manager must also obtain a relevant management and care qualification at an advanced level. From discussion with the registered manager, it is understood that arrangements have now been made for the registered manager and two further members of the Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 Page 20 management team to commence the required course of study in the near future. As recommended in the last inspection report, a detailed annual development plan should be developed for the home and made available at inspection based on a systemic cycle of planning, action and review. Although it is acknowledged that all staff have undertaken the appointed person first aid course and the registered manager is of the opinion that this is sufficient for the needs of staff and residents in a care home, the recommendation is that never the less at least one person who has obtained the ‘First Aid At Work’ course should be on duty at all times. Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X X X X 3 Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 Page 22 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 2. 3. 4. 5. Refer to Standard OP16 OP19 OP28 OP31 OP33 OP38 Good Practice Recommendations It is recommended that an individual complaint form be devised to record any complaint raised and the action taken. The external window frames and windowsills of the home require attention to ensure they remain of an acceptable standard. A minimum ratio of 50 trained care staff (NVQ Level 2 or equivalent) should be achieved by 2005. The registered manager should have a qualification at level 4 NVQ in management and care (or equivalent) by 2005. It is recommended that the annual plan be redeveloped to be comprehensive. A qualified first aider who has undertaken the more advanced First Aid At Work course should be on duty at all times. Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Redlands Rest Home DS0000009765.V277373.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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