Inspection on 13/09/05 for Redwalls Nursing Home

This inspection was carried out on 13th September 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.

Other inspections for this house

Redwalls Nursing Home 09/10/08

Redwalls Nursing Home 27/09/07

Redwalls Nursing Home 13/02/07

Redwalls Nursing Home 16/02/06

Redwalls Nursing Home 14/02/05

Redwalls Nursing Home 12/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Redwalls Nursing Home Weaverham Road Sandiway Northwich Cheshire CW8 2ND Lead Inspector Helena Dennett Unannounced Inspection 13th September 2005 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 Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 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. Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Redwalls Nursing Home Address Weaverham Road Sandiway Northwich Cheshire CW8 2ND 01606 889339 01606 883287 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) Redwalls Care Services Ltd Ms Helen Barnett Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. This home is registered for a maximum of 40 service users in the category of OP (old age, not falling within any other category). Room 24 must not be used for any service user who requires nursing care. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection. The matter detailed in the attached schedule of requirements must be completed by the stated timescales. 14th February 2005 Date of last inspection Brief Description of the Service: Redwalls is a care home providing nursing and personal care and accommodation for up to 40 older people. Redwalls is a large converted property the original being a grade 11 listed building and standing in its own grounds of 1.5 acres. It is situated close to the local amenities and village of Sandiway, which is approximately five miles from Northwich town centre. The home is a three-storey building with the ground floor and first floor accommodating residents. Residents accommodation currently consists of 34 single and 3 double bedrooms. 31 single and 1 double bedroom have en-suite facilities. The remaining bedrooms have hand-wash basins fitted. There are two lounges and a conservatory on the ground floor and a third lounge on the first floor. The dining room is situated on the ground floor next to the kitchen area. There are separate toilets and a variety of bathrooms. There is a hairdressing salon situated on the ground floor. A nurse call system is provided in all resident areas. The residents primary clinical needs are due to a physical frailty and infirmity or chronic physical disability in old age. In accordance with statutory regulations the home is staffed with registered nurses, carers, and ancillary staff at all times. Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 7 hours. The inspector spoke with seven residents and two relatives. In addition one service user comment card was received following the inspection. Their comments are included in the report. What the service does well: What has improved since the last inspection? A manager has been appointed since the last inspection. She is registered with the CSCI and is experienced in care home management. A new shower has been fitted to the downstairs bathroom. This improves the facilities available for the residents. Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 Page 6 A new carpet has been provided in the corridor upstairs and in the hairdresser’s salon. The recording of medicines on the Medicine Administration Sheets (MAR) has improved. 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. Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 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 the following standard(s): 3 Assessments of people’s care needs are carried out before they move into the home so there is information to show that their needs can be met at the home. EVIDENCE: Residents said that the manager of the home visited them before they moved in. They found this to be a positive experience. One resident recently admitted to the home was observed reading the statement of terms and conditions. In the files examined there was evidence of assessments carried out before the resident moved into the home. The assessment covered all aspects of personal care, and any specialised care that might be needed. Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 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 the following standard(s): 7,8,9,&10. The care plans include information on all residents’ care needs and how these are to be met so residents are safe and well at all times. Residents health care needs are monitored closely so that any deterioration in condition is recognised and addressed quickly. The medicines are well managed so that residents receive their medicines as prescribed. EVIDENCE: Residents and relatives said that staff meet their needs at the home. The comment card received from a resident indicated that the resident felt safe and well cared for. Individual plans of care are in place and these are evaluated regularly. The manager discussed some problems staff are experiencing with current documentation and intends to change these so that the care delivered to residents will be recorded clearly. Risk assessments including nutritional risk assessments are documented in the care plans, these are also reviewed regularly. Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 Page 10 There was evidence in the care plans to indicate that staff monitor residents health and where necessary seek the advice of a specialist, for example the GP or tissue viability nurse. Residents are nursed on specialised mattresses if required. Daily records on the resident’s health and well being are kept. Medicines are well managed at the home. Recording on the Medicine Administration Sheets has improved since the last inspection. On entering the lounge two members of staff were seen moving a resident in an incorrect way. The manager dealt with this immediately and expressed the opinion that this was not acceptable and that further training and supervision would be organised without delay for those members of staff. Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,37&38 There are plenty of activities available to meet the needs of the residents and to keep them stimulated and active. Visitors can visit at any reasonable time. Residents are enabled to exercise choice and control over their lives. Meals are well presented, varied and balanced providing adequate nutrition for residents to keep them healthy. EVIDENCE: Residents and relatives said there were plenty of activities provided at the home. One resident said ‘you would never be bored here’. One relative said that she enjoyed the art lessons that are held weekly for residents and any relative that wish to join in. Residents discussed the card games and one resident in particular enjoys the games of whist that go on regularly at the home. A bowls tournament was held recently for residents at the home and residents also said that they enjoyed the summer fair. The residents said they particularly enjoyed the group of dancers that had visited the home the previous day. One resident said that he also enjoyed the ‘man with the guitar’ that visits regularly. Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 Page 12 Members of staff and relatives were very positive about the owners input into the activities in the home. They said that the owners had organised various activities, made sure every resident had a Christmas present and organised activities on Valentines Day. The priest visits weekly and the vicar monthly. Visitors were seen entering the home. One visitor who spoke with the inspector said that she quite often brings cream cakes etc. in for a group of residents in the lounge to have with their afternoon tea. All of the residents in the lounge said that they enjoyed this. Residents who spoke with the inspector said that they choose what time to get up and go to bed and staff accommodate this. When asked whether residents can exercise choice, one resident said ‘I do what I like here’; another resident said ‘I can suit myself ‘. All of the residents spoken with complimented the food. They said they get a choice of meals and if they don’t like the choice the cook will try to arrange an alternative. They said the food is hot, of good quality and well presented. Sherry is offered to residents as an appetiser before lunch. The chef confirmed that when the owners are in the home they have the same lunch as the residents and will feedback their comments on the quality of the food to her. The menus were varied and contained a good balanced diet. Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Information about the complaints process for the home is readily available so residents and their relatives know how to make complaints and who to make them to. Staff knew what action to take if an allegation of abuse was made so that residents are not placed at risk. EVIDENCE: There is a clear complaints procedure, which identifies the action to be taken in the event of a complaint. Residents knew who to go to if they wished to make a complaint. Members of the care staff spoken with knew what action to take should an allegation of abuse be made. Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 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 the following standard(s): 19, 23 & 26 A programme of decoration and upgrading of the home is ongoing. The standard of décor and furnishings is satisfactory; residents’ bedrooms are comfortably furnished, providing people living at the home with safe and comfortable surroundings. The home was clean and tidy providing a good standard of hygiene with no unpleasant smells. The flooring in the kitchen requires attention to prevent the risk of cross infection occurring. EVIDENCE: The owners of the home took over approximately twelve months ago. They are in the process of re-decorating and upgrading some of the facilities. Since the last inspection a new shower has been installed downstairs for residents to use. The stairs leading to room 31 have been removed and a ramp provided so that disabled residents are now able to use this room. A new carpet has been provided in the corridor upstairs and in the hairdresser’s salon. Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 Page 15 The owners have acknowledged the fact that other areas of the home will require painting and decorating and a plan is in place to do this. Residents said that they were very happy with their environment. One relative confirmed that she was given a choice on which single bedroom her relative could have when she became anxious that she was occupying a double room and may have to share her room with someone. The gardens of the home are very well maintained. Residents were seen to walk around the gardens during the day. Residents and relatives said that the home is always clean pleasant and hygienic. All areas of the home seen by the inspector were clean and tidy. A gap was noted in the kitchen floor, which could be an infection control hazard; some attempts had been made at a repair however this was not fully successful. The owners agreed that the flooring would require replacement, however this would require considerable planning as the kitchen would be out of action for some time, however in the interim the flooring would be repaired. See Requirement 1. Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30. There were plenty of staff on duty so that the needs of the residents could be met. EVIDENCE: All of the residents and visitors/relatives said that there were sufficient numbers of staff on duty to meet the needs of the residents. They said that staff attended to their needs and they felt confident of their abilities to care for them. The manager and one member of staff was attending a course on the morning of the inspection. There were thirty-six residents in the building. Two qualified nurses and six carers were on duty. Staff were seen to interact well with residents, a happy and relaxed atmosphere appeared to exist. Recruitment records were examined for two staff. These had the relevant checks in place, however for one member of staff who had come from abroad in April 2005, whilst work permits etc were in place, there was no police check for that person from their home country. See Recommendation 1. Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 Page 17 Members of staff who spoke with the inspector said they felt very supported in their training. The infection control nurse specialist visits the home to do regular talks with staff. The continence nurse specialist has also done some training at the home. Staff confirmed that they had attended fire training and moving and handling training in the previous twelve months. The home now employs 51 care staff with NVQ Level 2 and above. There are 5 NVQ assessors on site. On entering the lounge two members of staff were seen moving a resident in an incorrect way. The manager dealt with this immediately and expressed the opinion that this was not acceptable and that further training and supervision would be organised without delay for those members of staff. Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,37 & 38. The manager is experienced and qualified so the home is run well for the benefit of the residents. Resident’s views are sought and acted upon. There are good systems in place to make sure that the health welfare and safety of residents is maintained at all times. EVIDENCE: The manager of the home is a registered general nurse and is registered with the Commission for Social Care Inspection. Residents spoken with stated they could approach the manager at any time if they needed to. Staff confirmed that they feel comfortable approaching the manager or owners of the home and that they are treated well. The atmosphere of the home was relaxed and residents appeared happy. Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 Page 19 Relatives and residents also complemented the manager and the owners of the home. They said the manager and the owners speak with residents and relatives frequently and felt this was a very positive aspect of the home. An internal quality assurance system is in place. Resident/relatives questionnaires are used and their views are acted on. Regular audits on care planning and medicines are carried out to make sure that residents are receiving the care they need. The manager confirmed that all electrical appliances are maintained regularly. The fire alarm is tested weekly and the emergency lighting monthly. All staff are offered moving and handling training. Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 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 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 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 3 3 3 X X X 3 3 Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 Page 21 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 OP19 Regulation 23 Requirement The kitchen flooring should be repaired or replaced. Timescale for action 30/10/05 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 Refer to Standard OP29 Good Practice Recommendations The registered person should ensure that for staff from overseas, a police check from the country the person has lived in, is obtained in addition to the enhanced CRB disclosure. Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Redwalls Nursing Home DS0000018791.V249473.R01.S.doc Version 5.0 Page 23 - 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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