Inspection on 09/10/08 for Redwalls Nursing Home

This inspection was carried out on 9th October 2008.

CSCI found this care home to be providing an Good service.

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 27/09/07

Redwalls Nursing Home 13/02/07

Redwalls Nursing Home 16/02/06

Redwalls Nursing Home 13/09/05

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 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Redwalls Nursing Home Weaverham Road Sandiway Northwich Cheshire CW8 2ND     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wendy Smith     Date: 0 9 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Redwalls Nursing Home Weaverham Road Sandiway Northwich Cheshire CW8 2ND 01606889339 01606883287 info@redwalls.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Carole Mary Evans Type of registration: Number of places registered: Redwalls Care Services Ltd care home 43 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The registered person may provide the following category of service only: Care home with nursing: Code N, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP (maximum number of places: 43). Physical disability: Code PD (maximum number of places: 1). The maximum number of people who can be accommodated is: 43. Date of last inspection Brief description of the care home Redwalls is a care home providing nursing and personal care for up to 43 older people. It is a large converted property standing in its own grounds. It is close to local amenities in the village of Sandiway, approximately five miles from Northwich town centre. The home is a three-storey building and accommodation for residents is on the ground and first floors. There are 41 single and one double bedrooms, most of which Care Homes for Older People Page 4 of 25 0 1 Over 65 43 0 Brief description of the care home have en-suite facilities. There are two lounges and a conservatory on the ground floor and a lounge on the first floor. The dining room is on the ground floor next to the kitchen. The scale of charges range from £600 to £640 per week. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. We visited Redwalls unannounced on 9 October 2008 as part of this inspection. Two inspectors carried out the visit. At the time of our visit there were 41 older people living at Redwalls. During the visit we spoke with residents, staff and visitors. We walked round the building to see all the communal areas and were able to visit some of the bedrooms. We checked some of the records kept at the home and spent time talking with the manager of the home. We also looked at any information that we had received about Redwalls since our last Care Homes for Older People Page 6 of 25 inspection there. Before the inspection the manager was asked to complete a questionnaire to give us information about the service. What the care home does well: What has improved since the last inspection? What they could do better: The care plans could be improved by being made more person centred and individualised. This would help to make sure that staff have the right information to provide individual care for each resident. The bathrooms could be improved to provide a more pleasant environment for residents to take a bath or shower. Care Homes for Older People Page 8 of 25 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are interested in going to live at Redwalls are given information about the home to help them make a decision. The home manager assesses the needs of all prospective residents to make sure that their needs can be met at the home. Evidence: Redwalls provides a total of 43 places, and 41 older people were living there when we did the inspection. The manager had arranged to go and visit two people who were interested in going to live at the home. Written information, including the activities plan and menus, is given to prospective residents and their relatives to help them find out more about the home before they decide to move in there. Care plans that we looked at showed that the manager had assessed peoples care needs before they moved into the home to be sure that this would be the right home for them. Information about the support they needed had also been provided by a Care Homes for Older People Page 11 of 25 Evidence: social worker/care manager. This helped to make sure that they could get the support they needed at Redwalls. Redwalls does not provide intermediate care. Care Homes for Older People Page 12 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Redwalls receive a good standard of care to make sure their needs are met in the way they prefer. Evidence: Each person who lives at the home has a care plan that contains an assessment of their needs and guidance for staff about how these needs should be met. The care plans are reviewed monthly to make sure they are still effective and up to date. There is a lot use of core care plans which are pre-printed. These should then be adapted to reflect individual needs. We thought that the care plans we looked at had not been sufficiently personalised for individual residents and often lacked meaningful information. For example, people were reported to require minimal assistance with diet, which does not tell the staff what help they may or may not need at mealtimes. Another example was the use of needs assistance with hygiene needs, which again does not give any information to the person reading the care plan. Similarly daily Care Homes for Older People Page 13 of 25 Evidence: entries in the care plans need to be more specific, as the use of phrases such as remains frail are not very informative in identifying peoples daily progress. The care plans include records of visits from health care professionals including the speech and language therapist, tissue viability nurse, dietician and GP. We spoke with a GP who visits the home every week and he told us he was satisfied with the care provided to his patients at Redwalls. We looked at the arrangements for storage and handling of medicines. Space is limited but the staff had made sure that all medicines were stored correctly. Administration records we looked at showed that people get their medicines as prescribed by their doctor. The medicines are checked regularly by senior staff to make sure that improvements made to medication procedures following the last inspection have been maintained. We spoke with a number of residents and their relatives and all expressed their satisfaction with the care provided at Redwalls. People considered that their privacy and dignity were maintained and that they were treated with respect. People told us, this is a lovely place, the staff are very good, cant fault it, food is really good and l have a lovely room. Care Homes for Older People Page 14 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are able to exercise choice about their daily lives and there is a range of regular social activities so people can keep active by taking part in activities that appeal to them. Evidence: An activities organiser works at the home four days a week and residents were positive about the activities provided. There is a structured activities programme and this is displayed on noticeboards and copied to residents. A record is kept showing what activities people have joined in. Some people enjoy going out to the local church hall for afternoon tea, and to church on a Sunday. There is a monthly communion service from different denominations. Friends and relatives are welcome to join in social events, which helps the residents to keep in touch with their families and friends. Residents have a choice of sitting areas, with two lounges and a conservatory on the ground floor and a smaller lounge on the first floor. On the day of our visit people were enjoying visits to the hairdresser and this seemed to be a lively social event. Visitors we spoke with said that there were no restrictions on visiting and they could see their relative either in a lounge or in the privacy of their own room. Care Homes for Older People Page 15 of 25 Evidence: People living in the home were very positive about the meals provided. During the morning, tea, biscuits, and fruit were offered to people. Choices are available at all meals. Lunch appeared to be a social occasion for those residents who had chosen to eat in the dining room. The menu was clearly displayed so people knew what choices were available for them at each meal. Adapted cutlery is provided as necessary to help people maintain their independence during mealtimes. When we walked round the home we saw that people had been able to make their rooms more personal and homely using belongings they had brought with them when they moved in. Care Homes for Older People Page 16 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are protected because there are thorough procedures for addressing complaints and safeguarding so that people can be confident that any concerns will be dealt with effectively. Evidence: Residents and their relatives are given information about how to make a complaint and the complaints procedure is displayed in the entrance area of the home. The manager keeps a record of any complaints received; five complaints had been recorded during 2008, none of which were of a serious nature. The records showed that complaints had been investigated and action taken where necessary. The manager told us that the owners of the home are also made aware of any complaints received so they can make sure they are resolved. There are policies and procedures about safeguarding residents from abuse for the staff of the home to follow. The training records we saw showed showed that staff have received training about safeguarding adults from abuse. This training is regularly updated to make sure staff know what to do if there is an allegation that a resident may have been abused. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Redwalls is well maintained both inside and out so it provides a comfortable, clean and safe environment for people to live in. Evidence: The home is surrounded by mature gardens that are well-maintained by contractors and provide a very pleasant environment for residents to enjoy. Most parts of the home were seen to be in a good state of repair. All areas we saw looked clean and there were no unpleasant odours in any parts of the building. The home is comfortable, bright, clean and safe for the people who live there. However, the bathrooms did not match the standard of the rest of the building and there were loose tiles on walls and bath panels, and badly marked flooring. We were told that refurbishment work was due to take place to upgrade the bathroom downstairs. This should provide a better standard room for residents to use safely. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Thorough recruitment procedures are followed to make sure that new staff are safe and suitable to work with vulnerable older people. Staff do a range of training to make sure the can provide a good standard of care for the residents of Redwalls. Evidence: There are two nurses and seven care staff on duty during the day, and one nurse with three care staff at night. In addition, there are two members of staff working in the kitchen each day, two cleaners and a laundry assistant. There are also two part-time members of staff who look after maintenance of the building. This means that the staffing levels are high enough to make sure that the needs of the residents are met. The home employs 28 care staff and 78 of these people have an NVQ level 2 in care so they have the skills and competence to provide the care the residents need. We looked at personnel records for three members of staff who had been recruited recently to work at the home. These showed that all of the required checks were carried out before they started working at the home, to make sure they were suitable to work with the residents of Redwalls. The records show that all new staff go through a thorough induction process and that all staff receive regular supervision to support them in their work. This means that residents can be confident that staff have the support and guidance to provide the care they need competently. Care Homes for Older People Page 19 of 25 Evidence: An experienced nurse is employed to provide training for Redwalls staff. A member of staff told us how much the staff appreciated support from the trainer. There are also four other moving and handling instructors working at the home. This means that staff always have access to up to date advice and guidance on moving and handling so they can undertake this safely for the residents and themselves. Training records showed that staff are kept up to date with mandatory training that ensures they know how to work safely. In addition, a number of staff had attended training events covering subjects including infection control, emergencies in the home, swallowing difficulties and falls prevention to help them develop and maintain their skills and competence in working with the residents. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed by a competent person to ensure that the best interests of residents are always the priority. Evidence: The manager is a nurse who has considerable experience of managing care homes. She is working towards a management qualification and has been registered with the Commission as the manager of Redwalls. The manager holds regular staff meetings and a monthly surgery for relatives so that staff and relatives can have a say in how the home is running. Dates for all of these were displayed on noticeboards. A satisfaction survey has been carried out recently to find out what people think about the home and a good response was received. There were many positive comments including, Everything is good and the staff are excellent. My Mum is happy there, thanks a lot for the love and care you give to all your patients. Regular audits of medicines and care plans are conducted to make sure Care Homes for Older People Page 21 of 25 Evidence: the medicines are given to residents safely as prescribed by their doctors and that their care plans are kept up to date. Staff, managers or the owners of the home do not manage the financial affairs of any residents or hold any money on behalf of residents. Regular health and safety checks are carried out by the homes maintenance people. A service folder gives details of when all plant and equipment are checked and serviced and these were all up to date to show that the home continues to be safe for the residents and the people who work there. We saw training records that showed staff are kept up to date with mandatory training to protect the health and safety of everyone in the home. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The care plans need to be developed so they are more person-centred and give accurate information to staff on what they need to do to meet each persons individual needs. Work needs to be done to improve the bathrooms to provide a more pleasant environment for residents to take a bath or shower. 2 19 Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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