Inspection on 04/05/06 for Redwell Hills Care Home

This inspection was carried out on 4th May 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Redwell Hills Care Home 28/05/08

Redwell Hills Care Home 30/05/07

Redwell Hills Care Home 10/10/05

Redwell Hills Care Home 08/06/05

Redwell Hills Care Home 15/02/05

Redwell Hills Care Home 20/07/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Redwell Hills Care Home St Ives Road Leadgate Consett Durham DH8 7SN Lead Inspector Mrs Sue Lowther Unannounced Inspection 4th & 30th May 2006 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 Redwell Hills Care Home DS0000000742.V300083.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. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redwell Hills Care Home Address St Ives Road Leadgate Consett Durham DH8 7SN 01207 581366 01207 591192 redwell.hills@fshc.co.uk 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) Four Seasons Homes (No 1) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Care Home 50 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (36), of places Physical disability (5), Terminally ill (5) Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Physical disability. Persons with a physical disability (aged 55 and over) may be accommodated commensurate with the home’s statement of purpose. 10th October 2005 Date of last inspection Brief Description of the Service: Redwell Hills is a purpose built care home located in a residential area on the outskirts of Leadgate. The home provides accommodation for older persons offering 24 hr general nursing and residential care for service users. The home offers single room accommodation, several of which have en-suite facilities. There are adequate additional toilets, bathrooms and communal sitting/dining areas. The home offers attractive outdoor sitting areas with a pleasant rural outlook. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection (CSCI) has a statutory duty to inspect all care homes. This unannounced inspection was carried out in accordance with this duty. The inspection took place on the 4th May 2006 & 30th May 2006. Records were examined and a tour of the building took place. Time was spent talking to service users, staff and relatives. The peripatetic manager supplied information on a pre inspection questionnaire. Five service users and five relatives returned surveys to the CSCI. What the service does well: What has improved since the last inspection? There has been some improvement in the care planning process. Those that are in place have been evaluated regularly. An activities coordinator has been employed for 20 hours per week. Service users spoken to confirmed that a range of activities has now commenced. The programme of redecoration has continued since the last inspection, but is not yet complete. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 6 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. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 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 Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 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): 2&3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some service users have not received a contract. Admissions to the home are well managed. Service users receive appropriate information about the home and their needs are assessed prior to admission. The home does not provide intermediate care and therefore assessment of Standard 6 is not applicable. EVIDENCE: Two of the people spoken to during the inspection process said that they had not received a contract and were unaware of the service they could expect to receive. The fees charged at the time of inspection ranged between £363 and £412 per week. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 9 All service users are assessed prior to coming into the home. In addition to care manager assessments the peripatetic manager normally visits the service user in their current place of residence. The manager advised the inspector that she would sometimes take another person with her if she feels this is needed. If she is on holiday this would be done by a qualified nurse and care staff where appropriate. The file of one service user recently admitted to the home was found to contain comprehensive information. The family said that they had looked around the home. They had been supplied with all of the information they needed to make a decision about whether or not their relative would like to live there. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Each service user has an individual care plan but some require more comprehensive information to ensure that all care needs are appropriately met. There is no evidence to confirm that these plans have been written with the agreement of the service user. Service user health needs are met by providing access to a range of other health and care professionals. The management of medication within the home is adequate with the exception of storage. Service users said that they are treated with respect and that their privacy is upheld. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 11 EVIDENCE: The peripatetic manager confirmed that all of the service users have care plans. Four were looked at in detail. All could be more detailed, but they give a reasonable idea of basic needs. The inclusion of social needs and individual likes and dislikes would improve the plans and give care staff more direction to meet all of the needs of the individual. Service users and their relatives should be more involved in the care planning process. Evidence was seen in files of involvement with other people for example district nurses, G.P’s, and care managers to confirm that other professionals are involved. Five of the people spoken to said that they usually receive the support and care they need. One said ‘ I feel care and support is administered well’. Another relative said ‘ My mother has always had the best of care and attention in the 6 years she has been at Redwell Hills. The staff are most helpful. I receive courteous and polite comments on every situation I ask regarding my mother.’ The medications of four service users were checked. The peripatetic manager told the inspector that she carries out a weekly audit to make sure everything is in order. The treatment room used for storage requires redecoration and some of the cupboards need to be replaced. The manager told the inspector that she has asked for quotes to see how much this will cost. Service users said that staff are always polite to them and call them by the name they prefer. They also said that staff knock on bedroom doors and wait to be invited in. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 12 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): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Activities do not always match the expectations and preferences of service users. Relatives and friends can visit at any time. Service users are not always consulted with regard to activities. The meals are of a good standard. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 13 EVIDENCE: Five service users spoken to commented on activities. Two said that they were usually suitable, one said that they were sometimes suitable and two said that they were never suitable. Relatives said ‘ My mothers eyesight is not good but she gets involved with what is going on’. Another said that her mother is unable to take part because she is bed bound. The manager told the inspector that the activities organiser is speaking to people on an individual basis to try and create a programme that suits individual needs and wishes. Relatives said that they could visit at any time and that they are always welcome. The husband of one service user said that he spends most of the day in the home and is always provided with a meal and drinks. The comments with regard to food were good. These included ‘ The kitchen turns out amazing food’, and ‘ meals are 1st class- anything available we need’. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints and adult protection systems in the home serve to safeguard service users. EVIDENCE: Information about complaints, how and who to make them to, is made available to service users and their families through information displayed on the home’s notice boards and in the home’s ‘Service Users Guide’. Service users’ and families’ views are obtained through regular contact and an ‘open door policy’. Residents meetings are held, which provide an additional forum to discuss any concerns or potential difficulties. ‘Resident Surveys’ have also been carried out within the home. The survey results have been published and are made available. Five surveys were returned to the CSCI. One person said that they did not know how to make a complaint. The manager said that she would reinforce the process at the next meeting. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 15 The home has detailed complaints and adult protection procedures. Copies of these were seen to be available for staff use. Staff interviewed voiced a commitment to the service users they work with and to upholding service users’ rights. Policy and procedure documents relating to adult protection provide information and guidance to staff. A copy of Durham and Darlington Adult Protection Committees policy and procedures on adult protection matters is held in the home. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 16 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, 21 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home was clean, comfortable and well maintained providing service users with a safe and pleasant environment. However two bathrooms were being used as storage resulting in reduced bathing facilities being available to service users. EVIDENCE: A programme of redecoration was ongoing at the time of the inspection. Those areas completed were found to be bright and cheerful and were in a style liked by people living there. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 17 Service users said they liked being able to bring into the home small items of furniture along with photographs to make their own room more pleasant and homely. The communal areas of the home were clean and service users confirmed that their bedrooms were also cleaned to a good standard. Comments received from service users were very positive. One said ‘The home has been decorated to high standard and is very clean. Sometimes it does smell a little but not nearly so bad as it used to’. Another said ‘Nicely decorated recently.’ During the tour of the building the inspector saw that two of the bathrooms were being used for storage purposes. These must be cleared and be available for use by service users. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 18 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 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 settled and well-led staff team, in sufficient numbers to meet the needs of the service users currently accommodated. EVIDENCE: Staffing levels are maintained at those advised by the company’s guidelines following a calculation based on the dependency levels of the service users accommodated. On the residential unit upstairs there are two care assistants on duty 24 hours per day. For the remainder of the home there is one qualified nurse 24 hours per day. There are five care assistants during the morning. This is reduced to four care assistants during the evening and three at night. The activities coordinator works for 20 hours per week, the handyperson for 30 hours per week and there are domestic, kitchen and laundry staff available between the hours of 07:30 and 18:00hrs every day. Most of the service users spoken to said that staff were always available and one person said ‘There is always someone in sight who is ready to seek whoever is in charge.’ However one person said ‘Staffing levels should be higher in my opinion all be it the home is within correct staffing levels. Can be quite stressful at times with staff tied up with other complex residents’. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 19 Staff have been recently trained in Dementia Awareness, Food Hygiene, Risk Assessment, Moving and Handling and fire training. Staff spoken to felt that the Dementia Awareness training had been particularly good and had changed the way they look after service users. Training planned in the near future is to include Protection of Vulnerable Adults and Health and Safety. Due to staff changes within the home only 42 of staff are currently trained to NVQ Level 2. However several staff are currently enrolled on the course and once these have completed it there will be over 50 of staff with this qualification. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 20 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, 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home does not currently have a registered manager. The peripatetic manager is providing support and guidance to staff and residents. Systems and safeguards are in place to ensure the health, safety and welfare of service users and staff is protected and that the home is run in the best interests of service users. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 21 EVIDENCE: A peripatetic manager is employed by the company to cover the home until a manager can be found. This has been the case for over a year and the company must seek to recruit a manager as a matter of urgency. There was an open and friendly culture between the management team and the staff at the home. Staff said that they felt well supported in their work and evidence in staff files confirmed that regular supervision of staff takes place and that staff are appraised. Service users and relatives confirmed that the manager was approachable and that they would go to her if they had any concerns. Regular meetings are held and the company have a number of systems in place to consult service users. These include monthly audits by the regional manager where she talks to service users and relatives about what life is like in the home. The administrator is responsible for the record keeping with regard to service user finances. She was able to identify the amount that each resident had in his or her account. The homes health and safety file was examined. All equipment in the home is regularly checked with certificates available to confirm this. There are no outstanding issues from the environmental health or fire and rescue service inspections. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 22 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 2 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 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 2 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES 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 OP2 Regulation 5(1)(b) Requirement Each service user must be supplied with a statement of terms and conditions in respect of accommodation to be provided for service users including the amount and method of payment of fees. The service user plan must contain evidence that they have been consulted with regard to their care. Sufficient bathrooms must be available for use. A minimum ratio of 50 of staff (excluding the registered manager) must be trained to NVQ Level 2 or equivalent. The company must seek to appoint a suitable person to manage the care home. (Previous requirement Timescale of 31/01/06 not met) Timescale for action 31/07/06 2. OP7 OP8 OP14 OP21 OP30 15(1) &(2)(c) & (d) 23(2)(j) 18 31/07/06 3. 4. 31/07/06 30/09/06 5. OP31 8&9 31/08/06 Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP12 OP9 Good Practice Recommendations Appropriate arrangements should be made to address the leisure and social interests of service users. The current storage facilities within the treatment room should be reviewed. Redwell Hills Care Home DS0000000742.V300083.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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. 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