Inspection on 20/12/06 for Redlands Rest Home

This inspection was carried out on 20th December 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 12/01/06

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 20th December 2006 10:00 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.V315872.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 Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 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.V315872.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th January 2006 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.V315872.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over a midweek day and in total spanned a period of approximately six and quarter hours. At this inspection, all of the key national minimum standards identified in ‘Care Homes For Older People’ were assessed. On the day of this inspection visit, 19 service users were in residence. The inspector spoke with the registered manager, two members of the management team and two of the care staff team. In addition, individual discussion also took place with three service users. Informal general discussion also took place with several other service users in a communal area of the home. A number of records were examined and a partial tour of the building took place. Prior to the inspection, although no Commission for Social Care Inspection service user comment cards were received from service users, two comment cards were received from friends of service users living at the home. This provided additional information on how friends of service users felt that Redlands was meeting the needs and requirements of people who live there. Information was also gained from a pre inspection questionnaire completed by the registered manager. The current scale of fees is £294 60 to £352.50 weekly. What the service does well: Redlands Care Home provides a high quality service for service users who live at the home. 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 different needs and wants and wishes of each individual person. The majority of staff have worked at the home for a long period of time and know the service users well. This ensures that the people who live there enjoy a continuity of care that helps them feel comfortable, safe and well supported. Before a service user is admitted to Redlands, the management team at the home have in place very good systems to make sure that the prospective service user’s needs, wants and wishes can be met and that staff have the skills and knowledge to provide a good level of care. Written care plans, that tell staff what the individual person can do for themselves and what help they would like or need are well written and detailed Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 6 and reviewed on a regular basis to make sure that the information remains up to date. Individual help, support and assistance are very well provided at this home. Service users can choose what they want to do and when they want to do it. Social activities are encouraged either independently in the local community or individual outings with a member of staff. Visitors are also made welcome. The staff group at Redlands are well trained in a wide range of topics however a nationally recognised training programme for care staff should be undertaken by further members of the staff team. What has improved since the last inspection? What they could do better: The registered manager and staff are keen to provide a high quality service at Redlands and work hard to ensure that the needs of service users are well met. However there are a small number of things that should be attended to. Further members of the care staff team should obtain a nationally recognised qualification in care that is specifically designed for staff working in care homes. The registered manager should complete the management qualification that has already commenced. A qualified first aider that has undertaken a more advanced of first aid training should be on duty at all times. Part of the external environment of the home, especially windowsills, still requires attention to prevent further deterioration. Redlands Rest Home DS0000009765.V315872.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 Rest Home DS0000009765.V315872.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 Rest Home DS0000009765.V315872.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): 3 Quality in this outcome area is excellent. The pre admission assessment information obtained from a variety of sources that identifies what the prospective service user can do well and what help may be required is detailed and comprehensive in order to establish if current needs, wants and wishes could be met at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection in January 2006 four new service users have been admitted to the home. Redlands Care Home has a structured pre admission assessment system in place to establish if current needs, wants, wishes and requirements of prospective service users could be met at the home. As the vast majority of service users accommodated are from out of the area, in most instances, the initially assessment of current strengths and needs is undertaken by a care manager of the prospective service user’s funding authority or through the Health and Social Services multi agency assessment Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 10 process. A representative of the home also routinely visits all prospective service users in their existing environment in order to complete an initial assessment to establish if Redlands Care Home could meet current needs. This process is further supplemented by a detailed assessment of strengths and needs undertaken by the management team at the home along with relevant risk assessments. In practice however, as the vast majority of service users accommodated have previously lived a considerable distance from the home, in reality the home’s individual assessment and risk assessments are completed only after admission. As observed at the time of inspection, the collated assessment information forms the basis of the initial care plan. A recently admitted service user spoken with confirmed that the representative of the home who had explained about the care home and the facilities and services provided had visited him in his previous environment. There was clear evidence that the assessment process took into account the diverse needs of each prospective service user for example sexual orientation or individual health requirements to ensure they could be met while living at the home. Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 11 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, & 10 Quality in this outcome area is excellent There is a clear and consistent care planning and risk assessment system in place that gives specific guidance to staff in order for them to satisfactorily meet service users needs and requirements. The health care needs of service users are well met with evidence of good multi disciplinary working taking place on a regular basis. The medication in this home is well managed promoting good health. Personal support is provided in such a way as to promote and protect service users’ privacy, dignity and independence. This judgement has been made using available evidence including a visit to this service. Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 12 EVIDENCE: All service users at Redlands Care Home have an individual plan of care that incorporates the outcomes of individual risk assessments and clearly identifies the individual service user’s current strengths, needs, wants and wishes. The promotion of equality and diversity is given high priority within the home. Individual diversity requirements are identified on the care plan and care is taken on how to manage the attitude of other some service users living at the home who may show less tolerance to the needs of others. Care plans evidenced were comprehensive and detailed, reviewed on a monthly basis and amended as required to reflect changing needs. All care plans are in the main, drawn up in consultation with the individual service user and signed by the service user. However on occasions, this is dependent on the appropriateness of the action, given the nature and need of the individual concerned. As at previous inspections service users spoken with were unconcerned about the written content of their individual care plan, but confirmed that their needs, wants and wishes were being fully met. From observation during the course of the inspection visit, the majority of service users are forceful and vocal in expressing their immediate views and would have no hesitation at expressing their displeasure if they disagreed with any part of the care plan as it was put into practice. Through discussion with service users and staff and observation of documentation, it was confirmed that service user’s health care needs are fully met. There is a good relationship with health and social care professionals in order to maintain health and social wellbeing. Comments from friends of service users on the Commission for Social Care Inspection, comment cards confirmed that they felt that people who live at the home always receive the medical support they needed. Positive comments have also previously been received from local General Practitioner practices that stated staff were always helpful and liaised well with them in promoting the health of service users living at the home. Arrangements were recently made for two service users to benefit from the input of a private physiotherapist who now visits on a weekly basis. The physiotherapist has devised ‘tailor made’ packages of individual exercise that staff encourage and supervise the service users to complete several times a week. Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 13 This programme of exercise has significantly reduced the number of falls experienced and the service users are both enjoying the social aspects of the physiotherapist visits. All service users who wish to and have capacity to do so are enabled to self medicate within a risk assessment framework. The home has good systems in place for the receipt, recording, storage, handling, administration and disposal of medicines in order to safeguard service users. There are very good detailed records with regard to medication that includes a written description of each drug complemented by a colour chart indicating the colour of each particular drug in respect of each service user. This provides clear guidance to staff that have responsibility for the administration of medication. All but the most recently appointed members of staff have received medication training and those with responsibility for the administration of medication have successfully completed a more advanced twelve-week distance-learning course in respect of drug abuse and misuse. In addition, an independent pharmacist visits the home on a regular basis to undertake a pharmacy inspection and also provides advice to the home on medication matters. Service users spoken with confirmed that they felt that their privacy and dignity was well respected and that “staff are very good and show respect”. Policies and procedures in respect of privacy and dignity are available to guide staff to make sure that these values are not compromised. All staff received training in respect of maintaining privacy and dignity during induction training and through regular supervision. Again there is clear recognition of the diverse needs of service users. For example, there is only one female service user currently living at the home. Consideration had been given to bathing facilities to ensure that the female service user had the privacy she required. Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 14 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 & 15 Quality in this outcome area is good Service users are encouraged, wherever possible, to keep in regular contact with family and friends in order to maintain family and friendship links. 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. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users at Redlands Care Home are encouraged to determine their own social activities and there is flexibility to enable people who live at the home to enjoy the life style of their choice as observed during the course of the inspection visit. As a result of the previous transient lifestyle of the majority of service users accommodated at Redlands Care Home, contact with relatives and former Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 15 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. The majority of service users enjoy 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. Some service users also enjoy a foot and/or hand mini pedicure/manicure. Individual care plans clearly identify the diverse choices of service users accommodated. There was good evidence of an individually arranged activity in the community with a member of staff that has included several service users visiting the Football Museum in Preston. Outings are also arranged to a local hotel that provides entertainment for people who may have difficulty in accessing community activity independently. An illumination trip was arranged and a number of service users also regularly enjoy a drink in a local café with a member of staff. All service users with capacity and who wish to do so are encouraged to remain independent in respect of their own financial affairs. However as previously, 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 for service users at Redlands Care Home is a main focus for the day and provides a varied and balanced menu that is designed around the known likes and dislikes of service users living at the home. As always, service users spoke very positively about the variety and quality of the meals served. A choice of menu is available and service users can choose a meal they would like to be provided such as a curry occasionally. Currently two service users require a diabetic menu and specific diabetic foods are provided. No current service user had any specific cultural/religious dietary needs. This would however be identified during the pre admission assessment process. The registered manager stated that research would be carried out if the home were unsure how to meet specific dietary requirements. Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 16 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 & 18 Quality in this outcome area is good. 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. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaint procedure at Redlands Care Home is fully compliant with requirements and identified in the Statement of Purpose and Service User Guide. As recommended in the last inspection report, in order to ensure confidentially, any complaint received is now 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. Since the last inspection, one complaint was received and investigated by the management team at the home. However the complaint was not about the home but a disagreement between two service users who both complained about each other. The method of investigation and outcome were recorded. Both service users were informed of the outcome and there has been a definite Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 17 improvement in the relationship between the two service users concerned since their complaints were investigated. 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 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. Recently, all staff with the exception of the most recently appointed member of staff, has undertaken refresher adult abuse training. This has incorporated an information pack (including the home’s policy on adult protection issues) and a comprehensive and detailed written questionnaire that was evidenced at the time of inspection. One of the more recently appointed members of the care staff team confirmed that she had undertaken the adult protection training and displayed a sound knowledge of the subject. Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 18 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 & 26 Quality in this outcome area is adequate. The standard of the internal environment within this home is adequate in providing service user with a comfortable place to live. Although attention has been given to some of the external elevations and windows, further attention is required to some areas to prevent further deterioration. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service Users at Redlands Care Home continue to 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 people who live there the opportunity to move freely round the building and access all areas with ease. Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 19 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 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 to first and second floor bedroom accommodation. Since the last inspection, new floor covering has been provided to the downstairs toilets, some new windows have been provided to the front of the property, a new patio door has been fitted to the dining room along with new flooring and new chairs and furniture has been purchased for one of the lounges. In addition the majority of bedrooms have been provided with a new bed. Redecoration of bedroom accommodation is ongoing throughout the year. Several months ago as the result of an incident and on the advise of the Police, a locking facility was provided to the front door of the property. However the device fitted does not allow service users independent access either going out of the building or returning. However from discussion with the service users individually spoken with this was not seen as a problem. There is a buzzer by the front door that the service user presses when wanting to leave the building and staff then activate a switch located elsewhere to release the door. The majority of service users in this home have been assessed as not appropriate to hold an independent key to the property. Whilst this system seems to be working adequately during the waking day when a number of staff are on duty, during the night time period a reduced number of staff are in the home. In order to prevent unnecessary risks, it is recommended that a specific risk assessment be carried out with regard to the locking device provided. It is also recommended that the Lancashire Fire and Rescue Service be contacted for advice regarding fire safety and to ensure that the locking mechanism would be deactivated in the event of a fire. 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.V315872.R01.S.doc Version 5.2 Page 20 Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 21 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 & 30 Quality in this outcome area is good. Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their quality of life. The arrangements for staff training are very good with staff demonstrating a clear understanding of their roles. However further members of the care staff team should undertake National Vocational Training. Adequate supervision arrangements are in place that means service users are supported by a competent staff team. There is a structured and robust recruitment process applied in order to protect service users This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing levels at Redlands Care Home are determined in accordance with the assessed needs of service users accommodated. Additional staff are on duty at peak times of activity during the day time and evening period and at night, a ‘waking watch’ member of staff is on duty along with a person who is ‘sleeping in’ on the premises. There is sufficient staff employed in various capacities to Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 22 ensure standards in respect of domestic and catering arrangements are maintained. Service users and staff spoken with all felt that there were sufficient staff on duty at any one time to ensure that the needs and requirements of service users could be adequately met. There is a clear commitment to the training and development of all staff that work at the home. However, although care staff are very positive and proactive in attending specific short course training for example, adult protection and medication training, the majority of staff are less keen to undertake nationally recognised National Vocational Qualifications (NVQ) training in care. The manager explained that staff feel the short course training is relevant and useful in their job, where as there is less confidence in the usefulness in undertaking NVQ training. Currently two members of the staff team have achieved an NVQ in care and two further members of the care staff team have expressed an interest in perusing this award. It is understood that the training for these two members of staff is to be arranged in the New Year. 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 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 Care Home has in place a structured recruitment policy and procedure that helps to protect service users. Since the last inspection, several new members of staff have been appointed. From observation of three recently appointed staff member’s personnel file, it was evident that the recruitment policy and procedures had been followed. This included an application form, health questionnaire, formal interview, references and a Criminal Records Bureau (CRB) POVA clearance had been obtained prior to the applicant actually taking up post at the home. A newly appointed member of staff confirmed that procedures had been followed and she was not allowed to take up post at the home until satisfactory references and a CRB (POVA) clearance had been received. The home’s induction process for newly appointed employees at Redlands begins prior to employment and continues when employment commences. It was evidenced that the new employees have all successfully undertaken the specific ‘in-house’ induction training programme and it is understood that some of the recently employed members of staff have commenced the ‘Skills for Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 23 Care’ induction training programme. Very recently appointed members of staff are to commence the ‘Skills for Care’ induction standards in the near future. Since the last inspection, the majority of staff have undertaken training in a variety of topics that has included, fire training/awareness, medication, food hygiene, challenging behaviour, moving and handling, adult protection and first aid. For the more experienced members of the staff team this was considered as refresher training. As observed at the time of inspection, the behaviour of some service users can challenge the service. An incident occurred when a service user became verbally abusive and aggressive. The staff member remained calm and in control and successfully defused the situation before speaking quietly and calmly with the service user about his behaviour and what had prompted the outburst. Service users spoken with, including the gentlemen involved in the above incident, all spoke very highly of the staff group and the level of care and support provided. Comments from friends of service users identified on the Commission For Social Care Inspection comment cards also expressed pleasure with the service provided with one stating: “My friend is very happy living at Redlands where I know the staff are very friendly, caring and helpful” Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 24 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 & 38 Quality in this outcome area is good. The manager is very experienced and well supported by the senior staff in providing clear leadership throughout the home. The manager is currently undertaking the Registered Managers Award The home regularly reviews aspects of its performance through a good programme of self-review and consultations, which include seeking the views of service users, staff and relatives. The system in place satisfies the needs and wishes of current service users. Financial procedures in respect of service users monies and the safekeeping of valuables is robust to protect the interests of service users accommodated. Systems are in place to ensure as far as possible the health and safety of service users, staff and visitors. This judgement has been made using available evidence including a visit to Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 25 this service. 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. Since the last inspection, the registered manager has also commenced the Registered Managers Award. This is a nationally recognised qualification for managers of care homes. In addition, two further members of the senior management team are also pursuing this course of study. Feedback from the training provider has been positive about the standard attained. However to date, progress in completing this qualification has been limited. Service users at Redlands Care Home are generally reluctant to cooperate in formal systems such as service user questionnaires to assist in the internal quality audit. Their preferred method is in using a verbal approach to explain how they think the home is meeting their individual needs as and when they see fit. However, periodically service users questionnaires are provided but the response is often very poor. Anonymous questionnaires for external stakeholders such as friends, medical personnel, care managers etc have been introduced that provide some feedback. In addition, Redlands Care Home has achieved the ‘Investors in People’ award that is nationally recognised and only awarded when a specific standard has been achieved. It was evidenced that policies and procedures are regularly reviewed and updated as required in light of changing legislation. There is a structured system in place for dialogue with staff on how the home is meeting its aims and objectives through daily discussion, staff meetings and regular supervision arrangements. All service users with capacity and who wish to do so are encouraged to control their own money. However there are a number of formal agreements with individual service users to enable the home to assist with daily budgeting of benefit entitlement and/or limit the amount of alcohol or cigarettes consumed in any one day. Secure facilities are available for the safe keeping of monies or valuables held on behalf of service users with clear, well-documented and relevant records Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 26 and receipts kept. In order to ensure service users monies held at the home are kept to a minimum, service users have been encouraged to open a saving account and to deposit monies appropriately in these accounts. Redlands Care Home ensures safe working practices are maintained through implementation of the home’s policies and procedures and staff training in respect of health and training issues. All except the most recently appointed members of the staff team have receive all mandatory health and safety training covering a variety of topics including moving and handling, fire safety, food hygiene, medication safe handling, infection control and first aid training that is updated on a regular basis. Refresher infection control training that is to take place in the near future will incorporate a video, and booklets accumulating in a written assessment of the training undertaken. Although staff routinely undertake basis first aid training, from discussion with the registered manager, it in understood that to date no member of the staff team has undertaken the more advanced ‘First Aid at Work’ course and there is a recommendation that a person who has undertaken this more advanced course of first aid training be on duty at all times. Observation of documentation confirmed that detailed maintenance/safety records and hazard environmental assessments are maintained. This includes, routine health and safety checks that are undertaken on a regular basis. It was noted that equipment is regularly serviced and there is a satisfactory system in place to prevent the risk of Legionella. Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 27 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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 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 2 X 3 X 3 X X 3 Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? N/A 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 Refer to Standard OP19 Good Practice Recommendations It is recommended that an environmental risk assessment be completed in respect of the recently fitted locking mechanism to the front door. It is also recommended that the Lancashire Fire and Rescue Service be contacted to confirm that the device conforms to the fire safety measures for the home. Some areas of the external environment of the property still require attention to prevent further deterioration particularly to windowsills. A minimum ratio of 50 trained care staff (NVQ Level 2 or equivalent) should be achieved. The registered manager should complete the Registered Managers Award. A qualified first aider who has undertaken the more advanced First Aid At Work course should be on duty at all times. DS0000009765.V315872.R01.S.doc Version 5.2 Page 29 2. 3 4. OP28 OP31 OP38 Redlands Rest Home Redlands Rest Home DS0000009765.V315872.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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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