Inspection on 11/05/07 for Redstones Care Home

This inspection was carried out on 11th May 2007.

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

Redstones Care Home 25/01/07

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Redstones Care Home Redstones 8 Surbiton Crescent St. Thomas Exeter Devon EX4 1PB Lead Inspector Rachel Doyle Unannounced Inspection 11th May 2007 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 Redstones Care Home DS0000067190.V335077.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. Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redstones Care Home Address Redstones 8 Surbiton Crescent St. Thomas Exeter Devon EX4 1PB 01392 421385 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) Redstones Care Home Limited Mrs Sally Louise Mary Richards Care Home 7 Category(ies) of Old age, not falling within any other category registration, with number (7) of places Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2007 Brief Description of the Service: Redstones is a large modern detached bungalow, which is situated in a quiet area of St Thomas. It is within walking distance of St Thomas shopping centre, the local health centre, post office, churches and other local amenities. The home has been extended to provide accommodation for up to seven service users, with five single bedrooms and one double bedroom, which is currently used as a single room. The Provider and their family live upstairs and have a private lounge downstairs. The home is clean, bright and furnished and decorated to a very high standard throughout. There is a good-sized garden that is well laid out and well used by service users during the warmer weather. The Home does not provide intermediate care. The average cost of care is £287-345 per week at the time of inspection. Additional costs, not covered in the fees, include chiropody, hairdressing and personal items such as some toiletries (the Home provides general toiletries for residents’ use as they wish) and personal newspapers. Previous inspection reports are available at the home in the hallway. Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Friday 11th May 2007 from 10.0014.00. On arrival there were two staff on duty, one being the current Registered Manager, and 5 residents at the Home. One resident is currently in hospital and their room was being re-decorated while they were away in the colour scheme that they wanted. Another resident was just off out for a walk with a relative and another relative was visiting in the lounge. The Manager was able to spend some time with us and the Provider, who was not on duty, came to show us the new paperwork and assist with the inspection. Three residents were spoken to in depth and one worker who visits the Home on a regular basis was spoken to on the telephone. Their comments are included in the report. Prior to the inspection surveys were sent to staff, residents, health professionals and relatives to obtain their views of the service provided; 7 were returned, 3 from health professionals and 4 from relatives. These were all positive in their comments about the service provided by the Home. We looked around the home and a number of records were also looked at. This included care plans, medication records/procedures, staff recruitment files, service and maintenance certificates, health and safety and fire safety records. Since the previous inspection we met with the providers to discuss the improvements that were being made with the running of the home. They were able to tell us all the improvements that they had made. For this visit the manager had completed a pre-inspection questionnaire, which gives us information about the home. What the service does well: Meals are home-cooked and the menu discussed with residents. All residents said that the food was good and that alternatives were available. Meals are very well managed serving varied, tasty and nutritious meals suiting individual preferences in a homely atmosphere. Residents said that they felt that they could raise any issues/concerns with the manager. The Home has a lovely homely feel and residents are able to be involved in the local community with their friends and relatives. The environment is well maintained and of a high standard ensuring that residents live in comfortable and clean surroundings. Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 6 Prospective residents are given good information to ensure that their needs can be met and that they can make an informed decision about admission. Medication and finances are well managed. All residents expressed satisfaction with the care that they were receiving and appeared comfortable with staff. There is a close, long-term staff team who know the residents well and work hard to maintain a family environment, whilst enjoying working at the Home. Residents’ privacy and dignity is well maintained and promoted by staff at the Home. Social activities are well managed, creative and provide choice and interest for those living at the Home. Residents are able to exercise choice and control over how they spend their day. What has improved since the last inspection? What they could do better: Care plans should contain more detailed information about monitoring residents’ general health on a regular basis, especially those at risk (such as tissue viability) to ensure that staff are able to clearly see deterioration or progress and when residents need access to specialist health care. The Protection of Vulnerable Adults policy should include important information such as reporting procedures to ensure that staff can easily refer to this information and act appropriately. Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 7 Staff job descriptions should reflect the role of individual staff, which is then reflected in their training records. The Home has good beginnings of a staff induction policy but this does not currently include care topics or a format, which follows Skills for Care principles. The Home has a good Manual Handling policy but this needs to clearly include how staff safely assist residents accidentally fall to the floor, such as assessment, the use of equipment, furniture, and any no-lifting policy especially as the Home does not have a hoist. If appropriate all residents who are at risk of falls should have individual risk assessments relating to this issue to ensure that staff and residents are not put at risk. The staff recruitment procedure must be made more robust so that staff are not working without supervision until a satisfactory Criminal Records Bureau disclosure has been received to ensure that residents are safe guarded. A clear policy relating to the management of residents’ finances should be developed. 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. Redstones Care Home DS0000067190.V335077.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 Redstones Care Home DS0000067190.V335077.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, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admission and assessment procedures have been formalised and now recorded ensuring that the Home is able to meet residents’ needs prior to them being admitted. Intermediate care is not provided. EVIDENCE: The Provider has worked hard to devise a comprehensive admission and assessment process for all prospective new residents at the Home. This has also been completed retrospectively for each current resident and is used as part of the care planning monthly review tool. Three assessments were looked at and these gave a good picture of what a residents’ needs were using a partly tick box format with space for additional Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 10 comments, which had been clearly filled in. The format covers a wide range of health and social care needs and is individualised and person centred. For example, if the tick box says that a resident wears glasses, the comment box details why and any additional notes such as range of sight or operations. General notes are also added to further complete the assessment including the reasons why a resident has chosen to receive a residential care service. The Provider visits all prospective residents and assesses them where it is convenient for them. Residents then receive a letter from the Home to confirm that their needs can be met in relation to the Home’s Statement of Purpose and staff skills. Redstones Care Home DS0000067190.V335077.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 good. This judgement has been made using available evidence including a visit to this service. The Home has a clear care planning process which, with minor improvement, will ensure that consistent and comprehensive health and social care is planned to meet residents’ needs. Medication is well managed at the Home promoting good health and residents’ independence. Residents’ privacy and dignity are well maintained and promoted by staff at the Home. EVIDENCE: The Provider has implemented a new care planning process to back up staff knowledge and ensure consistent care. The format is very detailed and comprehensive giving a clear picture of the residents’ as individuals and what their needs are. All aspects of the activities of daily living are covered such as mobility and communication as well as any mental health needs. Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 12 Staff record regular daily notes, which relate clearly to the care plan and it is easy to follow any deterioration or progress alongside records of health professional visits and actions. Short-term problems, such as breathlessness or swollen legs, are addressed separately and signed off when the problem is no longer an issue. The Home completes transfer forms detailing important information for a resident should they have to go to hospital which ensures continuity of care. Each plan has been discussed with the resident and signed by them. All residents preferred not to keep the care plan in their rooms but had open access to them. All plans are reviewed monthly. Health issues such as pressure sores are addressed and recorded on a separate sheet detailing what action the health professional has taken. These records are completed when a resident has developed a problem with their skin but there is no risk assessment and formal monitoring of tissue viability to show a preventative process for each resident, which would be good practice although the initial assessment does mention what a residents’ skin condition is like. Some residents have mobility problems and have had falls. The care plan details what equipment residents use and when and their risk of falls. Falls are followed up and audited using the accident forms. The provider said that staff have been assisting residents who have fallen up from the floor and was able to describe safe practices such as encouraging residents to help themselves up using furniture when able or if they were to be unable then health professionals would be called. The Home are discussing this issue with experts, as the Home does not have hoist equipment and looking into purchasing appropriate aids. The Manual Handling policy does not currently reflect this practice. Three surveys were returned by health professionals, including a General Practitioner and a District Nurse. All comments were positive. One felt that the Home had ‘a homely, quiet and welcoming atmosphere’ and that staff were attentive and ready to advise on any resident. They felt that staff spoke unhurriedly and patiently to residents, describing the Home as ‘a Home from Home’. Staff were felt to give a clear understanding of the needs of residents and that the overall care provided was satisfactory. One health professional, who has had a long relationship with the Home, commented that health care needs were always met, respecting individuals’ privacy and dignity and that the service sought advice and took action appropriately relating to health care. They said that it was ‘homely, safe and caring with residents appearing happy and content’. One relative felt that a resident’s outlook on life, mobility and well-being had all improved since they had lived at Redstones. Staff had taken care to encourage independence and mobility by helping a resident walk to the shops regularly. Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 13 Staff were seen to interact well with residents. One resident said that they loved the staff and staff had obviously built up a close rapport with residents and knew them well. Two visitors during the inspection also commented on passing how lovely the Home was and ‘such good care’. All residents spoken to were very happy with their care and loved living at Redstones. Two relative surveys commented that there was not anything they could think of that would improve the service, as this was considered ‘excellent’. The Home now has a new medication procedure using the Monitored Dosage System. The Provider felt that this was working well. They have substantial experience from their previous pharmacy work and training. Only staff who have had training in medication administration use the system. Records were clear and well managed. The Home encourages residents to be independent and each resident has a self-medication assessment. One resident has chosen to self-medicate and this has been thoroughly discussed with the GP and a self medication assessment completed, which will be regularly reviewed. The resident has lockable storage in their room and the assessment shows staff exactly how to help the resident remain independent in this field. Redstones Care Home DS0000067190.V335077.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. This judgement has been made using available evidence including a visit to this service. Social activities are well managed, creative and provide choice and interest for those living at the Home. Residents are able to exercise choice and control over how they spend their day. Residents’ contact with the community, friends and relatives is encouraged and facilitated by staff. Meals are nutritious and presented in a family-like setting ensuring that residents receive a balanced diet of their choosing. EVIDENCE: The Home has a homely, family feel and residents were seen to be able to choose how they spend their time. There are lots of opportunities for residents to participate in local events, outings with relatives or staff, visits from external entertainment such as local choirs and activities in the Home, especially playing cards, which all the residents love. The Home also recognise when residents wish to spend quiet time alone or chatting to other residents and although residents are encourage to take part Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 15 in activities their preferences are well catered for with respect. One resident enjoys reading in their room, others like to sit chatting in the conservatory area. One resident was off out for a walk and all residents have family who regularly take them out and are able to act as advocates. Residents like to contribute to the Home and the Provider said that one resident likes to bring back special vegetables for roast dinner, which the residents like. A care worker said that the Provider often spent time with residents chatting especially on Sundays and joining in with the Sunday services. There is a lovely photograph album showing various activities, which residents have enjoyed and attendance at a community end of season party is planned. All care plans have individualised ‘life stories’, which are excellent and activities are tailored to meet residents’ needs. Important details are recorded such as residents’ family relationships and who they like to visit. Plans also include daily activity records for each resident. Meals are home-made using mainly fresh ingredients and are very well presented. There is a lovely dining area and a menu board shows residents what to expect every meal. Many alternatives are available and staff are aware of residents’ likes and dislikes, which are recorded in care plans. All residents praised the food as did relatives. Meal times can also be flexible depending on what activity is planned. Redstones Care Home DS0000067190.V335077.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. This judgement has been made using available evidence including a visit to this service. Residents felt confident that they can raise any issue of concern, which will be acted upon appropriately. Residents are well protected by the Home’s procedures although improvements could be made in some written policies. EVIDENCE: All residents and relatives felt that the staff were very approachable and that any concern would be thoroughly looked at and acted upon. Residents are able to talk to staff or the District Nurse in private if they wish, who visits regularly. The Home has a good complaints policy and a complaints/concerns record book that shows how and when issues are acted upon. It was suggested that details are expanded on in the book but the Provider was able to clearly show that concerns had been properly dealt with to residents’ satisfaction. All staff have attended Protection of Vulnerable Adult training recently. Staff were able to say how they would manage an incident and knew about reporting procedures. The Home has a relevant policy, however this needs to be added to. It did not include clear guidance on local reporting procedures of any abuse and a summary of what is considered to be abuse. This would ensure that staff are always clear of the correct procedure as well as general information. Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 17 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 excellent. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the Home is excellent providing residents with homely, clean surroundings, which are well maintained. EVIDENCE: We looked around the home, which was very homely, warm and comfortable, and is like a family home. All the residents loved their personalised rooms. The lighting, heating, water and ventilation are of a domestic nature and meet the needs of the residents. The Home was very clean throughout and there were no offensive odours. The residents were all very happy with the environment and felt that it was like their own home. There is a lovely dining area leading into an open plan lounge through to a light and airy conservatory with comfortable chairs. Residents were enjoying a chat, receiving visitors in this area during the inspection. Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 18 Outside is a lawned area with garden furniture and flower pots for the summer months, accessed by a patio door. The Home in general blends in with other domestic bungalows in the area. All areas of the Home were clean and homely. The Home has a staff member who deals with maintenance and residents said how good this was. They could have shelves put up when they asked and any issues were dealt with immediately as they wanted. One resident’s room was being decorated while they were out and care was being taken that it was to their taste and to a high standard. A new carpet has been laid in the hall recently and general decorating throughout. There are paper towels and protective gloves and soap available. Substances Hazardous to Health are stored securely. The Home has an infection control policy and this is being updated with help from specialist health professionals. Infection control training for staff is planned in the near future. Staff said that there had been some District Nurse input in providing relevant equipment and leaflets. Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 19 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 adequate. This judgement has been made using available evidence including a visit to this service. Although formalised and improved since the last inspection, the procedures for the recruitment of staff are not fully robust to provide adequate safeguards to people living at the Home. Residents’ benefit from having experienced and friendly staff in sufficient numbers who have a good understanding of their needs. EVIDENCE: The Home maintains a strong staff team with a very low staff turnover. Staff have a good rapport with both residents and their families and this was confirmed by all the residents and two relatives who were visiting during the inspection. Two relative surveys commented that the care staff were ‘excellent’. There was the manager and one carer on duty at the time of the inspection with 5 residents at home, one in hospital. Staff were organising visiting this resident later in the day and would then feedback to other staff and residents. At night there are two sleep-in staff who are available at all times if residents need assistance. The Home is also the Providers’ home and the family have separate accommodation upstairs. Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 20 One resident commented that the staff were wonderful and like friends. Another resident said that the Provider ‘was a good friend to all of us’. All residents praised the staff and said that they were well cared for. Staff have obviously got to know the residents very well over time and pay attention to their wishes and preferences. Staff said that they enjoyed working at the Home. One relative stated that ‘the care home is very well managed and all the staff we have met are most helpful, pleasant and caring. Our relative is very fortunate to be at Redstones.’ The Home does have a clear induction programme for new staff but this does not include care topics or follow the recommended Skills for Care format. The provider will contact this organisation to devise an induction process for the Home. The Home has almost completed a comprehensive range of policies and has used the services of relevant health professionals and resources to ensure that they relate to the Home. These are discussed in staff meetings and staff sign to say they have read and understood them. Staff training has much improved and a staff training file clearly details the skills of individual staff. Mandatory training, such as First Aid and Moving and Handling is up to date and the Home will now look at specialist training such as infection control. It was suggested that care of pressure areas be included in this future training. There are 9 carers employed at the Home. Four are doing their National Vocational Qualification (a formal care qualification) and the Provider encourages this. Three staff recruitment files were inspected. There is a new recruitment process, which is very comprehensive including interview notes, clear application forms, terms and conditions and employment histories. All staff references were good and appropriately followed up prior to employment. One was a new member of staff. These three had Criminal Records Bureau satisfactory disclosures but the newest staff member had been working unsupervised at the Home for a period before the CRB had been returned, which does not ensure a robust safeguard for residents. One male member of the provider’s family is employed at the Home. The provider said that they did not carry out personal care for residents, who are all female. This was not documented but the provider said that this decision had been made between the family. This should be clearly documented in the job description to reflect their training needs. Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 21 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. This judgement has been made using available evidence including a visit to this service. The Home is well managed to promote and safeguard the health and safety of residents keeping them safe from risk of harm. Residents’ financial interests are safeguarded. Staff receive clear guidance to ensure that residents receive quality care in a safe environment. EVIDENCE: The new provider was registered with the Commission July 2006. As they have minimal recent experience in care they are currently working towards the Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 22 required Registered Managers Award and will also commence an NVQ 4 in Care. The manager, who was registered at the same time, has worked at the Home for many years but has recently decided to move on so the Home are advertising for a new manager, whilst the Provider works towards taking on this role in the future. The Provider is very passionate about caring for the residents and sees them as part of the family, spending a lot of time at the Home talking to the residents. All the residents praised the Provider and the manager saying that they could not do enough for them. The Home have a policy file which is being constantly added to and staff sign to say that they have read and understood each policy. The Home are aware of the procedure of informing the Commission of any incidences relating to residents in the Home. The foundations and documentation, which help to maintain a safe Home are now in place such as mandatory training, staff induction, admission assessments, residents’ care plans, staff policies (including Manual Handling and POVA), risk assessments and staff files. The Provider has worked very hard to ensure that this documentation is in place. The annual quality assurance audit is being done for 2006/7. The Home sends a questionnaire to relatives and residents separately. Comments were positive so far and the Home has a quality assurance questionnaire, which can be completed anonymously by residents and their families. Any comments needing action or reply need to be addressed and the report sent to CSCI once they have been collated. Radiators, which could present a risk to residents, are covered and others are risk assessed as low risk. There are also comprehensive environmental risk assessments. The Home use an external Health and Safety specialist who is helping the Home devise very detailed Health and Safety risk assessments and policies to ensure that residents are kept safe by regular checks. This includes a Health and Safety package that includes an annual audit by the company. This will also include staff personnel matters and recruitment in the future. Staff are up to date in Manual Handling training although the Moving and Handling policy needs to be updated, see under Staffing. The Fire risk assessment was very comprehensive having been done recently by a Fire Officer and the Home are working through the recommendations. The Home has fitted automatic door closers appropriately to ensure that fire doors are not wedged open and fire checks were all up to date. This area is well managed. Residents’ financial arrangements were discussed with the provider. They said that the Home does not deal with any residents’ financial matters as this is dealt with by residents themselves and families. Residents are able to have Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 23 lockable storage in their rooms if they wish or use the Home’s safe. There is currently no policy relating to finances but the Provider is looking into this. One relative commented that the staff always give support, full care and attention in all aspects of care needed by residents. They felt that staff listened to residents and fulfil their every need both materially and spiritually taking into account their preferences. Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 24 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 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 Standard No Score 16 3 17 x 18 2 4 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP29 Regulation 17 Schedule 2 Requirement Staff recruitment files must contain satisfactory CRB disclosures before any staff member is able to work unsupervised to ensure that residents are safeguarded. Timescale for action 11/06/07 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 OP7 Good Practice Recommendations You should ensure that care plans include a way of regularly monitoring residents’ tissue viability to ensure that preventative measures are taken and that specialist advice is taken appropriately rather than documenting only when a problem has occurred. You should ensure that the Protection of Vulnerable Adults policy clearly states the reporting procedures and what to report so that staff are sure of the process at all times to keep residents safe. You should ensure that all staff complete an induction on starting employment in line with recommendations from DS0000067190.V335077.R01.S.doc Version 5.2 Page 26 2. OP18 3. OP30 Redstones Care Home 4. 5. 6. OP33 OP35 OP38 Skills for Care (previously TOPSS). Staff terms and conditions of employment should make clear what roles staff are employed to do to ensure that all residents’ needs can be met by the staff on duty, namely whether personal care is undertaken and any relevant training is appropriate to meet residents’ needs. You should send a summary of collated Quality Assurance findings annually to CSCI. You should ensure that there is a clear policy relating to the management of residents’ finances. You should ensure that the Home’s Manual Handling policy includes how staff are to manage residents who have fallen to ensure that staff and residents are not put at risk. Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. Extracts may not be used or reproduced without the express permission of CSCI Redstones Care Home DS0000067190.V335077.R01.S.doc Version 5.2 Page 28 - 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. 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