Inspection on 29/08/07 for Redwood Care Centre

This inspection was carried out on 29th August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Redwood Care Centre 26/11/08

Redwood Care Centre 31/07/06

Redwood Care Centre 13/06/05

Redwood Care Centre 28/04/05

Redwood Care Centre 07/10/04

Redwood Care Centre 24/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Redwood Care Centre 179 Epsom Road Merrow Guildford Surrey GU1 2QY Lead Inspector Sally Hall Unannounced Inspection 29th August 2007 09:00 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 Redwood Care Centre DS0000059510.V342284.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. Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redwood Care Centre Address 179 Epsom Road Merrow Guildford Surrey GU1 2QY 01206 752552 01483 306514 admin.redwood@careuk.com manager.burroughs@careuk.com Care UK Community Partnerships Limited 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) Mrs Rosalyn Gaye Hampson Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The age/age range of the persons to be accommodated will be: OVER 65 YEARS OF AGE 50 beds providing nursing care for elderly people from the age of 60 years, of which 20 beds may be used for intermediate care. Additionally, one named resident in the age category between 60 and 65 years of age in the intermediate beds for the duration of his stay as per letter dated 9th March 2006. 12th September 2006 Date of last inspection Brief Description of the Service: Care UK is owned and operated by Care UK Partnerships LTD. The service is situated in Merrow, close to the town of Guildford. The service is a ground level building comprising of 5 units named Oak, Elm, Birch, Cedar and Ash. The main concourse is called Maple. The accommodation is arranged in 50 single occupancy bedrooms, 30 for long term nursing care residents and 20 beds catering for delivering intermediate care. There is ample communal and quiet space throughout the premises. The gardens are well maintained with parking places to the front and rear of the premises. Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection at Redwood House took place on the 29th August 2007 starting at 9am. The lead inspector was Sally Hall. On the day of the inspection the inspector agreed and explained the inspection process with the Deputy Manager. Time was spent reading a sample of care plans, written policies and procedures and records kept within the home. Staff were spoken with and a tour of premises was undertaken. The focus of the inspection was to assess Redwood House in accordance with the National Minimum Standards for Older People. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. The home was asked to complete an AQAA (Annual Quality Assurance Assessment). Evidence from this document is also included in this report. Unfortunately there was not time to send out surveys to residents, their families and other health professionals before this inspection. However, a large number of residents were spoken with during the inspection process. What the service does well: Individual plans of care, which detailed the agreed support from the care and nursing staff, are completed with the resident and their family if appropriate. They cross reference with the assessments and are clear, easy to follow and cover elements of risk prevention where necessary. Activities take place in the home throughout the week and are enjoyed by a number of the residents spoken with during the day. It was good to see that the home offers a very varied programme and things ‘a little out of the ordinary’. For example, on the day of inspection there was a well-attended talk on hats. Another activity had been the visit by a local farmer and staff with farm animals that residents were able to see and stroke. The home also has a shop were residents can buy items of toiletries, sweets crisps etc. One resident said, “I really enjoy the independence that gives me, I don’t like to keep asking the family to bring in things”. The home was found to be kept very clean and well maintained. There were no odours noticed during the day. The grounds also were well maintained. Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Redwood Care Centre DS0000059510.V342284.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 Redwood Care Centre DS0000059510.V342284.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents coming to the home for long term care can feel confident due to the assessment process they will only be offered a place if the home can meet their needs. Intermediate care clients can be sure that they will be enabled to reach their full potential before returning to their home. EVIDENCE: An assessment is undertaken for residents who potentially need long term care. The manager or her deputy does this prior to residents being admitted. Examples of these were seen in the files sampled and they covered aspects of the person’s physical, physiological and social needs. The home has emergency admissions when residents are sent straight from the local hospital. In these cases it is not possible to assess the residents prior to admission and they are normally admitted to the intermediate care unit Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 9 where they can be assessed. A meeting of the multi-disciplinary team is then held within 72 hours of that person’s admission. The multi-disciplinary team has undertaken monitoring of residents who have been admitted in this way. It has found that a large number of these residents return to hospital. The intermediate care unit has 20 places and is primarily for the assessment and rehabilitation of residents who have been in hospital following illness or perhaps had a fall at home. The unit has on site physiotherapists and occupational health staff who work alongside the staff at the home to provide a structured rehabilitation programme. Often it is about regaining confidence and learning to use aids that will help them remain independent and with support to return home. Redwood Care Centre DS0000059510.V342284.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, and 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can feel confident that their health, personal and social care needs will be met within a culture of respect that maintains their privacy. EVIDENCE: Residents’ files were sampled. Each contained an individual plan of care, which detailed the agreed support from the care and nursing staff. In this home records are kept up to date on a computer system, so as well as the files, the care plans were also viewed for some residents on the computer. These plans are reviewed monthly by staff or before if there has been a change in the resident’s condition/needs. The daily records seen by the inspector covered some of the care provided but they lacked detail; statements indicated ‘all care given’ rather than details of what specific care tasks were undertaken. Daily records could be improved significantly if staff recorded the care actually provided to each individual resident. It is also necessary to record the progress that is being made towards meeting set goals by residents in the intermediate care unit. It was still evident, from the observations of the inspector, that residents are receiving good care and residents’ special needs Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 11 are being provided for but, unfortunately, the daily records did not convey this fully. Regarding the intermediate care units, the multi-disciplinary team meets weekly to discuss each resident and the progress they have made and new goals are set for the following week. Records of these goals can be found in the inside of the resident’s wardrobe so staff can easily check the support they need to be giving. However, it was noted that the resident’s care plan does not reflect these changes, also the daily records kept by staff do not document the outcome for the resident. These areas of record keeping were discussed with the deputy manager. The records are written at the end of each shift and this time is recorded. However, there was no indication of the time care had been given or specific events had happened. Evidence was seen that the use of bed rails had been risk assessed and permission had been sought to install these. Health monitoring was evident and residents are enabled to access other health professionals at the home such as chiropodists, opticians etc. Residents’ benefit from having physiotherapists available within the home. The home uses the services of one local GP. The deputy manager confirmed that residents who wish may stay with their own local GP if they wish. Risks are identified through the assessment process. These are documented in the care plan along with a management strategy to reduce those risks. The computer also flags if there are risks for any individual resident as soon as the resident’s file is opened. For example, several care plans seen detailed the care required for residents with pressure areas and the preventative care for other residents who were at risk. The nurse, the senior carer or the key worker had reviewed the care plans seen on a monthly basis. Outcomes had been recorded for each part of the care plan. Medication was checked and audited in one of the two medication rooms and was found to be correct. The medication storage room was clean and well organised. All medication is locked in cupboards and there is a facility for the storage of controlled medication. The home has the majority of the medication dispensed in MDS (Monitored Dosage System) provided by the pharmacy. The Medication Record Sheets seen had been completed fully. The deputy manager confirmed the home has a monitoring system in place to ensure that residents are receiving the medication as prescribed by the GP. The deputy manager confirmed that the GP reviews residents’ medication on a regular basis. Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 12 Medical examinations and consultations take place in residents’ own rooms. The home has a number of areas in which visits can take place in private if a resident does not want to go to their bedrooms. The home has a public telephone that residents can use. Staff were observed to treat residents with respect and took care when enquiring about personal issues. All staff were seen to knock on bedroom doors before entering and responded quickly when help was called for. Residents spoken with at the time of the inspection confirmed that the staff at the home respect their privacy and dignity. The deputy manager explained they are adopting a scheme that will focus on helping people to end their days in the way they want to. Residents/relatives will be consulted regarding their wishes concerning their care arrangements prior to death; this will be documented and when that time comes, if possible, will be followed. The home will be using the Liverpool Care Pathways documentation and hope to reach a gold standard once the scheme is up and running. Training will be made available to staff that will help them deal with this very sensitive area of care. Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 13 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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can feel confident that there will be a full range of activities available during the week if they wish to take part. Family and friends are made welcome. Staff will offer choices so residents stay in control of their lives as much as possible while living at the home. The meals are nutritious and there is plenty of choice. However, meals are not currently home cooked but this may be changing. EVIDENCE: The activity co-ordinator documents in individual files on the computer system the activities that are going on and who has been involved. There is a varied programme through the week, which is advertised around the home either on notice boards or in some cases in resident’s bedrooms. The activity coordinator is aware that not all residents want to join in group activities or their condition means they are confined to bed. In these cases time is set aside to give some sort of input on an individual basis. The staff and residents talked about some of the activities that have been on offer in the past six months. A local farmer sent some of the farm workers along with some of the farm animals to the home. Residents went outside to meet them. This was a Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 14 particular favourite with one resident, who was brought up on a farm. She particularly liked touching the pony. Residents enjoyed it so much the farm has been asked to repeat the visit. There is a craft afternoon and items made could be seen around the home. Residents are now asking to do this more often and the activity co-ordinator said that she is often asked to ‘get the paints out’ on other days. There are exercise classes to music, which help residents with movement and mobility; one resident does a short programme every day and it is helping with their weight loss. On the day of the inspection there was a talk arranged about hats. Those who were there enjoyed this; several said they found it very interesting. There are many more activities and these are detailed for people to see in a folder kept in the entrance seating area of the home. The home has a shop and items are taken on a trolley around the home once a week for those not able to walk to the shop. It stocks items such as toiletries, sweets and crisps etc. Residents seemed to enjoy choosing their weekly goods. The activity co-ordinator is also encouraging the setting up of a residents committee at the home. They hope to have their first meeting at the end of the week. Family and friends are made welcome whenever they visit. If that happens to be at meal times then they are offered a meal with their relative. Some visitors who travel and who will be staying for parts of the day can book a meal in advance. Residents were overheard being asked to make a number of choices during the day, including where they want to sit to what they wanted to eat. Every opportunity was given by staff for residents to stay in control of their lives. The meals are brought in chilled and are heated and served in the home. The menu on the day offered a number of choices. Quality control means the meals are nutritious. However, none of the residents spoken with said that the meals were really good. Feedback received said things like “it is better than the food I had in hospital”, “it’s ok, nothing special”, ” it’s eatable”. The deputy manager explained that the home is going to start preparing home cooked meals for the residents in the future. They are advertising for a chef and the equipment is ready for the change in the kitchen. As meals often become the highlight of the day for residents it is important to provide meals that they look forward to eating. The staff record the choices made by residents each day and keep a record of how much each resident drinks. Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 15 Redwood Care Centre DS0000059510.V342284.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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives benefit from knowing the home takes all complaints seriously and use them to improve its service. Residents are protected by the home’s safeguarding adults policies and procedures. EVIDENCE: The complaints file was seen. These are also recorded on the computer along with action taken and outcomes. The manager had followed up those seen in writing. The complaints procedure was seen in the Statement of Purpose/Residents Guide. In one letter seen, in reply to a complaint, the manager had made it clear that the home welcomes complaints as a way to improve the service they provide. There has been one complaint since the last inspection and this has been dealt with appropriately. The home follows the local authority safeguarding adults protocol provided by Surrey Social Services. However, the manager does need to ensure that the protocol documents stay current by adding any updates as they are released on the Internet. The Protection of Vulnerable Adults (POVA) training is now being done as part of a computer-based training package. The staff, who are new, will have already done this way during their induction. Staff who have worked in the home for some time will have done it already and will update their knowledge via the computer training. Training records indicated that most staff have Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 17 done the training. The few that have not completed this training have been identified and will do the course soon. This training is to be repeated every three years. Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 18 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a safe, warm and pleasant environment. EVIDENCE: A tour of the building was undertaken. The décor throughout was the same, which made orientation of the building a little confusing. The deputy manager said that families found it difficult at times. The home was generally very clean, in a good state of repair and there were no unpleasant odours. Bedrooms seen had appropriate furniture for the resident and the size of the room. All bedrooms seen are single. Beds were appropriate for the individual resident’s needs and a number had bed safety rails installed. Evidence was seen that bed safety rails are assessed on an individual basis for each resident. The home is divided into units each with 10 beds. 20 beds are rehabilitation beds and are specifically for residents who need to regain confidence and skills following a stay in hospital so that they can go home and live independently Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 19 with support. The other three wings are for the long stay residents who have nursing needs. Two wings are sponsored by the local authority and another takes private residents. Each wing has an open plan kitchen, dining area and lounge, which lead onto residents’ bedrooms. There is also a main lounge, a shop and hairdressing room. The kitchen was seen; it was very clean and tidy. The laundry was well appointed and clean. There is a small area off the laundry for the storage of clean clothing waiting to be returned to the individual resident. The home uses red sacks that dissolve during washing for dirty linen. These are used to reduce the number of times dirty linen has to be handled by staff. Evidence was seen around the home of personal protective clothing (PPE) supplied to staff to reduce cross infection. The home lacks storage. There were a number of areas where hoists and wheelchairs were stored. These areas did not enhance the look of the home. Several bathrooms were seen; they were clean and tidy, had assisted baths and assisted showers. However, the bathrooms did not look very homely, and whilst it is important that they are easy to clean, it is important to make them nice places to ‘enjoy a soak’ in. The grounds are well cared for and there are a number of seating areas to choose from. School grounds back on to the site and the manager said that residents enjoy watching the children, particularly on sports day. Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 20 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confidant that they are protected by the home’s recruitment procedure and that there will be staff in sufficient numbers with the skills to meet their care needs. EVIDENCE: On arrival the inspector found the home was short staffed owing to sickness. The home was short by four staff both for the morning and afternoon shifts. However, the deputy manager was able to cover the home by using agency staff. The rota for the home was seen for the current week and the previous week. A large number of care and nursing staff work long days (12 hour shifts). This is not ideal, particularly when this is over a three or four day period. Problems can arise from staff continually working these long hours, one of these being sickness. The rota did indicate that when the staffing level is as per the rota then there are normally enough staff to cover the needs of the residents. The deputy manager confirmed that the rota can be flexible and extra staff can be added to the shift to cover particular residents needs. Due to the layout of the building this home needs more staff as it is divided into units. Each shift consists of two qualified nurses and care staff; 11 care staff in the morning, 10 care staff in the afternoon and four care staff at night. Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 21 Staff files were looked at random for five staff who had been recruited in the last year. Each file contained application forms and evidence that Criminal Records Bureau (CRB) checks had been sent for and received before the staff member had started working with residents. Each file contained two references and included a summary of the interview. Items of identification were seen for each person along with their photos. Signed contracts of employment were not evidenced in all files, the deputy manager confirmed that staff had been sent them but had not yet returned a signed copy; they are being reminded. The home has an induction training programme that is in two parts. There is time spent working with other staff and being shown around the home, familiarising with the layout of the building, fire exits etc. The induction training meets the National Training Organisation (NTO) workforce standards. The latter is done via a computer package that staff must complete, plus practical training for topics, such as, moving and handling. The staff can work through the training at their own speed, either during quiet periods while on shift or in their own time at the end of their shifts. Their work is monitored. A number of staff have completed their NVQ level 2 or above in care. However, the home has yet to reach the required numbers with the award. The deputy manager confirmed that a large number of staff have either started the award or are waiting to start the award in September. The number with the award would have been higher but staff leave for various reasons and this affects the total. Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 22 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, 32, 33 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from the warm and inclusive atmosphere within the home where their views will be listened to. Residents can also feel confident that their health, safety and welfare will be promoted within the home. EVIDENCE: The manager has been at the home for the past eight years and has a breadth of experience in caring for elderly people. She was on leave the day of inspection but her deputy, who is also experienced, was very helpful. The home has a warm and friendly atmosphere. Good interaction was observed between the residents, staff, and the deputy manager. Residents spoken with said that they felt comfortable asking staff for help and expressing Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 23 concern if they were not happy. The staff said that they feel supported and enjoy being part of a team. The home sends out its own surveys to residents and families to gain their opinion of the care provision in the home. They also have staff meetings on a regular basis. The deputy manager explained that they had approached residents recently to set up a residents’ forum; the first meeting had been scheduled for the week of the inspection. Residents’ finances were not seen during this visit but were correct at the last key inspection. The fire test record book evidenced that tests were being carried out in the home as required. The general principles of fire training are learnt via the computer learning packages but a practical application and awareness of fire procedures particular to the home are undertaken with all staff. There is a fire risk assessment in place. The compliance certificates for the lift (LOLER) and bath hoist were not seen but, like the certificates for the electrical installation, electrical appliances, fire alarm system, boilers, emergency lighting and the call alarm system the AQAA (Annual Quality Assurance Assessment) received confirmed these certificates had been obtained and are satisfactory Computer courses are being used for POVA, COSHH, Health and safety, food hygiene and care induction standards. The induction programme was looked at, as was the documentation that is completed following the learning of various subjects. This included a place for a mentor to sign to say they are satisfied that the new staff member understands the learning they have undertaken. Redwood Care Centre DS0000059510.V342284.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 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X X 3 Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 25 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 OP7 Regulation 15, Schedule 3 Requirement Ensure that the goals that are set on a weekly basis are evidenced in the care plan and the progress made towards these goals is reflected in the daily records. Staff must record in the daily report details of the care provided to residents, including the time of care delivery and specific tasks undertaken and in line with the service user plan of care, that has been generated from a comprehensive assessment (see Standard 3) and drawn up with each service user. Timescale for action 30/09/07 2 OP7 15 30/10/07 Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 26 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 OP27 Good Practice Recommendations It is recommended that the number of long days worked continually by staff over several days be reviewed, as tired staff can make mistakes and may lead to other issues. Redwood Care Centre DS0000059510.V342284.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Redwood Care Centre DS0000059510.V342284.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!