Inspection on 03/05/05 for Redlynch House Residential Home

This inspection was carried out on 3rd May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Redlynch House Residential Home 20/06/06

Redlynch House Residential Home 04/10/05

Redlynch House Residential Home 11/11/04

Redlynch House Residential Home 24/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Redlynch House Residential Home 19 Hillcrest Road Hythe Kent CT21 5EX Lead Inspector Julian Graham Unannounced 3 May 2005 9:30 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 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. Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Redlynch House Residential Home Address 19 Hillcrest Road, Hythe, Kent, CT21 5EX Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01303 264252 Redlynch Residential Home Limited Susan Constance Hambelton Care Home only 13 Category(ies) of Older People x 13 registration, with number of places Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Mrs Hambelton to undertake Registered Managers Award training Date of last inspection 11/11/04 Brief Description of the Service: Redlynch provides personal care for thirteen service users, and occupies detached premises. All bedroom accommodation is single and is on the ground and first floor. All bedrooms are fitted with call-bells and locks (other than one which leads to a fire exit).Mrs Hambelton, the Registered Owner along with her brother, Mr Miles, is also the Manager of the Home.Communal areas of the Home include a lounge and separate dining area. There are assisted bathrooms on both floors. Redlynch provides a good sized, and well maintained patio and attractive garden area for residents to use.The Home is located on the outskirts of the small sized town of Hythe with good access to shops, public transport and other public amenities, some of which are within walking distance. Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over two days and lasted nine and a half hours. The inspector spoke with nine of the residents during the course of the inspection, five of whom in the privacy of their own rooms. The inspector also spoke with the manager and four carers, two of whom in the privacy of the office. He also had the opportunity to speak with two visiting relatives and a Community Nurse. A tour of the home was undertaken, and the inspector was able to observe staff discreetly as they carried out their duties and interacted with residents. Some records were examined, including care plans and risk assessments, admission information, staff files and medication arrangements and records. During the course of the inspection, a resident told the inspector that she does not feel well treated by one of the night staff. The inspector discussed this with the manager who immediately spoke with the resident and reported the person’s allegations to Social Services under Adult Protection procedures. A member of staff had earlier in the inspection spoken with the inspector and referred to concerns she has regarding the care of residents at night by one of the night staff. These allegations are currently under investigation. What the service does well: Redlynch has a friendly and relaxed atmosphere, and with the exception noted above, residents spoke very warmly of the care they are recieving. One of the residents said that the manager “is like my best friend”, and another resident said that “staff are kind and treat me very well”. One resident who came to the home when very unwell, has made such progress as to be almost ready to return to her own home. This is a fine achievement. The resident said she would not have improved so quickly had it not been for the care and diligent support of the staff. Routines are flexible and dictated by residents’ choice. Meals are nutritious and nicely presented and residents can choose what and when they eat. Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, Admission procedures are poor with written Needs Assessments not consistently being undertaken prior to people moving into the home. Without this there is no assurance that care needs will be met. EVIDENCE: Individual records are kept for each resident and examination of three of these, including two of the most recent admissions, did not have the full assessment information recorded for them. There was no written preadmission information at all in respect of one of these. The nutrition assessment in respect of one of the residents was not dated. One resident, however, told the inspector that the manager had visited her before moving in and had talked to her about her needs and how the home can assist her. Another resident told the inspector that staff are helping her settle into the home and that she was asked when she moved in what her food preferences were. There was written evidence in support of this on the person’s file. Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 The health care needs of residents are generally well met with evidence of good multi disciplinary working on a regular basis. The systems for care planning and assessing risk are not always clear and consistent to provide staff with the information they need to meet residents’ needs. Residents are generally treated with care, respect, warmth and sensitivity. EVIDENCE: A sample of care plans were examined, and whilst most contained good, clear information detailing needs and how these can be met, this is not always being achieved, with one having several sections uncompleted, including needs in relation to washing and dressing. Some risks are being identified, recorded and regularly reviewed; with risks in relation to falling, for example, being seen in two of the care plans. One resident’s file contained no evidence of assessing risk. Residents who were spoken with all said that their health care needs are being met by the home, with one saying that staff will “summon the doctor straightaway” whenever the need arises. The inspector spoke with a visiting Community Nurse who said she is confident in the ability of staff who she described as “competent”. She said she is always contacted appropriately by staff. Not all weight monitoring charts are being kept up to date, however. Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 10 Arrangements for the control and administration of medication were examined, and clear, written procedures are available and accessible. The medication cupboard was neat and orderly, and improvements in the storage and recording of Temazepam have been made. All staff who administer medication have received training, although a recorded assessment of their competence is required. Some gaps in the MAR charts were noted and handwritten entries on these charts should be signed by two staff to minimise the risk of errors occurring. The inspector again advised the home to obtain a copy of the Royal Pharmaceutical Society’s Guidelines. There was much evidence in support of the home’s aim to promote the privacy and dignity of the residents. Residents were all looking nicely presented and well groomed, and staff demonstrated good understanding of these important principles. One resident said that she gets tea and coffee “at times that suit me” and another said she is free to rise and retire “at any time I like”. Residents said that staff knock on their doors and await an answer before entering and the inspector observed this happening during the course of the inspection. Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15 Residents’ social and recreational needs are being met; and contact with family and friends is encouraged and maintained. Meals are nutritious and well balanced and offer a healthy diet for the residents with some choice available. EVIDENCE: The inspector asked the residents whether they felt their visitors are welcomed, and typical responses were “oh yes, they are given a lovely tray of tea” and “they are well looked after and I can see them in private”. The two relatives spoken with confirmed they are made very welcome whenever they visit. Residents said that they are happy with the activities on offer, with many saying they prefer to spend time in their rooms and do not want group activities. They said that staff respect this and do not try to make them join in. Staff told the inspector that now a domestic is in post, there is more time for them to sit and chat with the residents, and the inspector saw this happening during the course of the inspection. Residents spoke very favourably about the meals provided in the home, with one saying “there is masses to eat”. Lunch time menus looked balanced and interesting and the meal on the day of inspection which the inspector shared with the residents was hot, tasty and nicely presented. The residents said they enjoyed it. The cook said she knows residents’ individual food preferences and Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 12 plans accordingly and it was noted that one resident chose something different from the main meal of the day on the day of inspection. Another resident is a vegetarian and told the inspector that the food is “wonderful” and that she gets ”all kinds of vegetarian dishes”. It is a recommendation of this report that records of the evening meals are more detailed to demonstrate the range of choices being offered. Currently these records are not being made at all or in insufficient detail. Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 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 standard(s) 16,18 The vulnerable adults procedure, whistle blowing policies and the Complaints Procedure are not working effectively to ensure that the people living in the home are protected from abuse. EVIDENCE: A staff member expressed concern to the inspector regarding the attitude and approach of one of the night staff towards residents. A resident made an allegation of neglect and verbal abuse in respect of one of the night staff to the inspector during the inspection. That the management had not picked up on these concerns suggests that insufficiently robust and effective systems are in place to properly identify when there is a risk of actual or perceived abuse. The home must ensure that staff receive training on protecting vulnerable adults from abuse and arrange for whistle blowing procedures to be strengthened to ensure staff feel able to report any concerns they may have and with the confidence that appropriate action will be taken. Whilst several residents told the inspector that the manager and staff ask them how they are every day, the systems for effectively seeking the views of the residents, including residents being able to complain without fear, need review and improvement. It was noted, however, that residents in the main referred to the manager and staff as being very kind and approachable and generally expressed much confidence that any concerns they may have would be taken seriously. Four complaints have been recorded since the last inspection with a record of the action taken. The outcome of the complaint investigation must also be recorded. Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 24, 25, 26 The standard of the environment is good within the home providing residents with an attractive, comfortable and homely place to live. There are some health and safety hazards requiring attention. EVIDENCE: A tour of the premises revealed good standards of hygiene and cleanliness and the home was free from offensive odours. A sample of bedrooms were viewed and these were attractively decorated and furnished to the taste of the occupants. Residents said they like their rooms and find them comfortable. A resident told the inspector that she had been told before moving in that she could bring any personal possessions with her. Communal areas are bright and comfortable and there is a well laid out garden area for the residents to use. The tables in the dining area allow for fewer residents to sit than the home is registered for. The manager said however, that some residents prefer to eat in their rooms, and that an additional table is available should this become necessary. Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 15 A risk assessment undertaken by the home has identified some radiators needing protection, but suitable guarding has still to be fitted. The inspector saw a resident clutching on to the radiator in the dining room. If the radiator had been on at the time, a real risk of burning would have been posed. The manager said that there are plans to protect the radiators. Liquid soap, paper towels and pedal bin are required in the upstairs toilets. Whilst the manager said that the hot water temperature is tested to ensure it is within safe temperatures, there were no records in support of this. Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 30 Since the last inspection, the standard of vetting and recruitment practices has declined with appropriate checks not being carried out and potentially leaving residents at risk. The deployment and number of staff is sufficient to meet the needs of residents. Staff training records are being poorly maintained. EVIDENCE: There has been minimal staff turnover since the last inspection. This consistency and continuity of care is of benefit to the residents. Staffing rotas showed a minimum of two staff on duty during the day, with the manager supernumerary on occasions, in addition to the cook and cleaner. There is an additional staff member to help with the suppers (between four and seven p.m). These numbers are sufficient to meet residents’ needs. Staff interviewed said they do not feel particularly rushed, and residents said that staff are prompt in their attention and that buzzers are answered speedily. The inspector has concerns, however, regarding the large number of hours the manager works each week. A number of shortfalls regarding the recruitment procedure were noted and improvements in this area must be made. Three staff files were examined and it was noted that one flexi staff member who was on duty at the time of inspection and had been working in the home for two weeks had not been POVA checked, and there was no evidence that a CRB check had been applied for. There was also just one reference for this person, and not from the previous employer. Health declarations are not being sought prior to appointment. Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 17 Five of the staff have a National Vocational Qualification, and a newly appointed staff member is due to commence this training in September. This represents a high percentage of staff with a qualification and is commended. Training records are not being effectively updated however, including induction training, and some core mandatory training is out of date. Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 35, 37, 38 The manager has good understanding of what needs to improve in the home and is aware that some standards relating to the administrative functioning of the home have slipped since the last inspection. There is a friendly atmosphere in the home. Residents’ rights and best interests would be better safeguarded, however, by more robust record keeping, quality assurance systems and thorough implementation of important policies and procedures, such as Complaints and whistle blowing. EVIDENCE: The manager is undertaking RMA training which is a Condition of the home’s registration. She acts as a good role model to the staff team, those of whom spoken to at the time of inspection demonstrating awareness of their role and responsibilities. Residents are benefiting from the general management approach of the home. Whilst residents are asked to complete feedback questionnaires from time to time, these are not very frequent and have not been obtained for a while now. A more systematic review and evaluation of Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 19 aspects of the home’s performance, including residents’ and other interested stakeholders’ views, would more effectively pinpoint and identify potential shortfalls and issues that could be speedily acted upon. Some staff are requiring refresher training on safe working practice issues, such as moving and handling. Staff are however receiving regular opportunities to attend fire training. Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 1 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 x x 3 2 2 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x 3 1 x x x 2 2 Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 21 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3 Regulation 14 Requirement Accommodation must not be provided to residents unless their needs have been assessed. That assessment must be in sufficient detail to enable care staff to meet residents needs. The assessment must be kept under review and having regard to any change of circumstances be revised as necessary. Residents care plans must be in sufficient detail to provide clear guidance to staff on the actions to be taken to meet their personal care needs. Risk assessments must be maintained and kept up to date. With regards to medication: a) a record of the assessment of staff competence in handling medication to be maintained. b) handwritten entries on MAR charts to checked and signed by two staff. c) MAR charts to be filled in following administration of medication. The manager must ensure that the complaints procedure is given and fully explained to residents. In order to ensure the protection H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Timescale for action 03/05/05 2. 7 15 03/06/05 3. 4. 7 9 13 13 03/06/05 a) 03/07/05 b) 03/05/05 c)03/05/05 5. 16 22 03/06/05 6. 18 13 03/06/05 Page 22 Redlynch House Residential Home Version 1.30 7. 25 13 8. 25 13 9. 29 19 10. 11. 30 33 19 24 12. 38 13 of residents, staff must receive training on adult protection procedures; the implementation of the homes whistle blowing policy must be promoted. Radiators must be suitably guarded in line with the homes risk assessment (timescale of 11/12/04 not met) Hot water temperature must be tested and recorded at suitable intervals. (timescale of 01/03/04 not met). The home must operate a thorough recruitment policy and practice, to include POVA and CRB checks and references being requested and obtained. Staff training records must be maintained and kept up to date. Effectiive quality assurance and monitoring systems, based on seeking the views of residents, must be in place. All staff must receive core mandatory training on safe working practices. 01/09/05 (revised) 03/05/05 (revised) 03/05/05 03/06/05 03/07/05 03/08/05 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. Refer to Standard 8 9 15 26 Good Practice Recommendations Residents to be weighed at regular intervals. The Royal Pharmaceutical Society Guidelines to be obtained. Records to be maintained of the evening meals. Disposable towels, liquid soap and pedal bins to be provided in upstairs toilet and bathroom. Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU 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 Redlynch House Residential Home H56-H05 S35297 Redlynch V222432 030505 Stage 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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