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Inspection on 25/05/05 for Redmount Nursing Home

Also see our care home review for Redmount Nursing Home for more information

This inspection was carried out on 25th May 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides a clean and comfortable environment for the clients to live in and a group of staff of different nationalities that bring enthusiasm and respect to the daily task of caring. The homes documentation, both care and maintenance is of a high standard and was freely available during the inspection. The Management team works hard, and in harmony, to deliver and monitor the care provided.

What has improved since the last inspection?

The home has recruited an experienced registered nurse into the position of Acting Registered Manager who is also experienced in managing this care home. She was previously the manager and took a break to work in the National Health Service for several years.

What the care home could do better:

No requirements or recommendations have been made in respect of this inspection.

CARE HOMES FOR OLDER PEOPLE Redmount Nursing Home 21 Old Totnes Road Buckfastleigh Devon TQ11 0BY Lead Inspector Douglas Endean Announced 25 May 2005 th 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. Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Redmount Nursing Home Address Your Health Ltd, 21 Old Totnes Road, Buckfastleigh, Devon, TQ11 0BY 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) 01364 642403 01364 642403 Your Health Ltd Vacant Care Home with Nursing 42 Category(ies) of Dementia - over 65 years of age (10), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (10), Old age, not falling within any other category (10), Physical disability over 65 years of age (35) Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Registered for maximum 10 OP Registered for maximum 10 DE (E) seervice users 65 years and over Registered for maximum 10 MD (E) service users 65 years and over Registered for maximum 35 PD (E) service users 65 years and over Date of last inspection 02/02/05 Brief Description of the Service: Redmount Nursing Home is situated within 150 yards of the main street of the town of Buckfastleigh, which is on the edge of the Dartmoor National Park. It is also just a short distance from the A38 / A384 junction at Buckfastleigh that leads to the cities of Plymouth and Exeter. The home is a large detached property that has been extended and adapted to provide care to physically disabled people who need both personal and nursing care. The accommodation is arranged on three floors that are served by two shaft lifts and two staircases. Service Users rooms, communal space and the kitchen area are contained on the first and second floors. The office, a meeting room/staffroom and laundry are situated on the ground floor. There are car parking space’s available at the front of the home. The garden and patio areas are accessible to all Service Users including those in wheel chairs. There are 26 single rooms and 8 shared rooms, the majority of which have en-suite facilities. The home is registered to cater for 42 Service Users (aged 65 and over), 35 of which are registered for Service Users who require nursing care. There are disabled toilets and bathrooms, and a variety of equipment including hoists and pressure relief aids that are available for Service Users who are assessed as needing them. The home has a registered nurse on duty at all times. The home is managed by an experienced registered nurse and a experienced administrative manager. Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and took place over a period of 4 hours 40 minutes. The inspector spoke to 4 clients and 3 staff in addition to the Nurse and Administrative Managers. Comment cards were received from 4 relatives and 5 clients. The inspector also was given a completed pre-inspection questionnaire and read twelve replies to the in house quality assurance questionnaires. What the service does well: 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. Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 6 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 Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 7 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. Standard 6 is not applicable. The home only admits patients who have needs that they can meet. EVIDENCE: The manager visits all prospective clients and carries out a comprehensive assessment of their needs. The assessment does cover such areas as medical presentation, communication and nutrition among its 14 areas. A sample of four completed assessments were looked at during the inspection when the inspector read four clients files. A blank copy of the assessment format was provided for the inspector’s information. In addition there was evidence in the files to show that additional information is gathered to help with decision-making and care planning. This information included care manager and district nurse assessment (NHS determination information) as well as hospital discharge information sheets. Neither the NHS nor Social Services supply the home with a copy of their determination assessment record for any client. Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 8 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 Manager and other trained nurses produce well-constructed care plans from which the staff focus their care delivery activities. The clients are treated in a respectful way. EVIDENCE: The inspector read a sample of five care plans. The information in them correlated with the information obtained in the initial and ongoing assessments such as assessed problems with mobility had warranted a care plan to deal with the issue. Other areas that form parts of the care plans seen by the inspector included sleep, nutrition, and communication. The General Practitioners involvement was recorded in each set of records that were read by the inspector. There was also information recorded by the chiropodist and the District Nurse where they had been involved with residents. The medication procurement arrangements were reviewed by the inspector and found to be satisfactory. Only the trained nurses manage medication and there were clear in house procedures seen for them to follow. The home also has copies of the Nurses and Midwifery Council guidance on administration of medication for the nurses to refer to. There are no clients who self medicate at the time of the inspection. Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 9 All the clients are registered with a General Practitioner. The preadmission form was seen to have a record of the client’s choice of gender of carer. No doors to client’s rooms have locks fitted but client’s are asked if they want a lock fitted and there response was seen to be recorded in the client’s file as was their wishes on how they are to be addressed. Screens were seen to be available where rooms are shared. Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 10 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. The home is run in the interests of the clients and their views are listened too by the management and staff. EVIDENCE: The recreation assessment and care plan, were seen to hold a record of client’s likes and dislikes for food and activities. The planned activities were displayed on a white board in the main lounge and on notices on the front door of the home. The home encourages visiting at any reasonable time and the inspector saw people dropping in to see client’s throughout the inspection. Client’s rooms were observed to be personalised during the inspector’s tour of the home. Each of the case files seen had a nutritional assessment that recorded special needs, such as a low fat diet, if supervision or help were required with feeding and the level of attention required for monitoring fluid intake. The home has a chef who is very experienced in this area of care and able to plan and provide special diets where they are needed. A specimen menu was supplied as part of the documentation given to the inspector. The inspector sampled the food provide for the clients during the inspection and remarked on its good taste and presentation. Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 11 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 home has taken the appropriate steps needed to recruit and train staff that are suitable to work with vulnerable adults. There are adequate measures taken to inform clients and advocates of their right to complain. EVIDENCE: The homes complaints procedure is displayed in the main reception area and in the statement of purpose that is in every bedroom. The inspector saw the complaints book that will be used to record any complaint, details of their investigation and outcomes. No complaints have been received by the Commission or the home in the last twelve months. The home asks in their quality assurance questionnaire for the client’s “Do you know whom to complain too?” Each of the four client’s spoken to by the inspector indicated clearly that they knew who to complain to if they needed to. The manager told the inspector that all staff have a POVA First check and Criminal Records Bureau check and staff recruited from overseas have a police check from their country of origin. Evidence of these checks was seen in the sample of 3 staff files that were seen during the inspection, 2 being from overseas staff. There was evidence that the home has followed its own recruitment procedure with the files see having application forms, references, interview records, and police/CRB checks. All staff have completed Protection of Vulnerable Adults Training run in house by Devon County Council staff. The home also has the Alerts guide and DVD. Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 12 Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 13 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 & 26 The home is clean, well decorated and maintained, providing a safe, comfortable environment for the clients to live in. EVIDENCE: The home was audited by the companies Health & Safety Officer during this inspection. The CSCI inspector saw the risk assessment recordings that have been carried out by the homes own in house Health & Safety person. They were of a good standard. Other recording methods were discussed. A large number of maintenance records were shown to the inspector during the inspection that provided evidence that the environment and equipment had been correctly maintained such as hot water boilers, shaft lifts and hoists. The inspector observed the home to be in good decorative order and in a good state of repair during the tour of the home. Staff are supplied with disposable gloves and aprons, coloured for tasks, white aprons for feeding at meal times and blue aprons for “dirty work”. Staff are also trained to understand the importance of hand washing between tasks. Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 14 There was evidence that Infection Control Training had recently taken place at the home. The home has one mechanical disinfecting sluice that can handle one commode pan at a time. Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 15 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, 29 & 30. There are adequate numbers of staff working in the home who have achieved a satisfactory level of training to meet the needs of the client’s. EVIDENCE: The duty sheets provided evidence of adequate numbers of staff being on duty each shift. The staff records and training information that were seen by the inspector provided evidence that the staff who are employed by the home collectively have the skills to meet the needs of the clients. There was evidence that showed the home employs currently registered nurses, a record of pin numbers were seen, who have maintained their nursing skills through continuous education and care staff who, if not a trained nurse but not registered in this country, have been trained in such things as infection control and lifting and moving. The homes recruitment procedure was seen and the sample of three staff records read by the inspector showed that these are followed for the protection of the client’s in the home. The induction process and a sample of records were seen. The process of induction is recorded and each step is signed off when completed such as when a procedure is discussed, when it has been demonstrated in supervised practice and when the staff member is competent. The staff training matrix was seen that showed all staff training that had taken place and by whom. A list of training has been supplied in the pre-inspection questionnaire. Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 16 Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 17 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) 33, 35 & 38 The Management team are providing a safe environment for the clients and the staff. EVIDENCE: A sample of the results of the in-house quality assurance questionnaires were seen that showed the views of clients are obtained on a regular basis. The CSCI received a total of 8 (eight) comment cards from relatives and clients that were discussed during the inspection and negative comments addressed. The staff-training matrix was seen and it showed that the training provided is aimed at improving the care to the clients such as manual handling, protection of vulnerable adults and infection control. The Manager showed the inspector that there were adequate arrangements in place to make contact with advocacy services should this be necessary. The Manager showed the inspector the arrangements for safekeeping of money and valuables and how storage of them are recorded. Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 18 The home was being inspected by the Company Health & Safety representative during this inspection. He was looking at outcomes rather than practical processes. Evidence was provided by the in house Health & Safety man of all the actual practical arrangements such as risk assessments and testing or maintenance of appliances such as thermostatic valves, shaft lifts and hoist’s and portable electrical appliances. The in house records were of a good standard in this area. Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 19 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 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 20 NO 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 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 Good Practice Recommendations Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Redmount Nursing Home D54-D07 S28789 Redmount V215870 250505 Stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!