Inspection on 01/02/07 for Redwood House Residential Home

This inspection was carried out on 1st February 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 House Residential Home 06/09/07

Redwood House Residential Home 08/11/05

Redwood House Residential Home 01/12/04

Redwood House Residential Home 25/05/04

Redwood House Residential Home 20/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Redwood House Residential Home 11 Cherry Hill Road Barnt Green Worcestershire B45 8LL Lead Inspector Andrew Spearing-Brown Unannounced Inspection 1st February 2007 09:30 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 House Residential Home DS0000018478.V310203.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 House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redwood House Residential Home Address 11 Cherry Hill Road Barnt Green Worcestershire B45 8LL 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) 0121 445 2268 0121 447 9700 admin@redwoodcare.co.uk Redwood Care Homes Ltd Mrs Nicola Jayne Hill Care Home 23 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (23), of places Physical disability over 65 years of age (23) Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 8th November 2005 Brief Description of the Service: Redwood House is a large detached house, set in extensive grounds consisting of mature gardens and lawned areas. Ramps and pathways enable easy access for residents. The home has recently had a passenger lift installed to enable ease of access to the first floor. Redwood House is registered to provide residential care for up to 23 older people who are frail, who may have physical disabilities or who may have experienced a mental health need. Accommodation is provided in 19 single bedrooms, 6 of which have en-suite facilities and two double bedrooms one of which has an en-suite. Respite care can be provided if there are vacancies. The stated aim of Redwood House is to provide quality care in a safe and comfortable environment, where residents have the freedom of choice in the management of their own lives and where they are treated with dignity and respect. Redwood Homes Ltd acquired Redwood House in March 1998. There are several homes within the group. The registered manager is Mrs Nicola Hill is responsible for the day-to-day management of the home. The pre inspection information received by the Commission prior to this inspection stated that fees at Redwood House currently range from £360.00 to £450.00 per week; the registered manager confirmed these figures during the second visit to the home. Additional charges are made for personal items such as hairdressing, newspapers and toiletries and private chiropody. Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An inspector from the Worcester office of the Commission for Social Care Inspection (CSCI) carried out this inspection. The focus of any inspection carried out by the CSCI is to assess the outcomes for people who use the service. As part of the overall inspection of the service offered at Redwood two visits to the home were undertaken. Both visits to the home were unannounced. The last statutory visit to the home, which was also unannounced, took place during November 2005. This inspection takes into account information received by the CSCI since the previous inspection as well as the visits to the home. A partial look around the home took place concentrating primarily on communal areas and facilities. The care documents of a sample number of residents were viewed including care plans and risk assessments. Other documents seen included medication records, some service records and some staffing records. The registered manager was not on duty on the day of the first visit however she attended the home following staff informing her that the inspector was present. In addition to the persons mentioned above discussions took place with some carers and the cook. Discussions took place with a number of residents throughout the inspection. What the service does well: The atmosphere within the home was welcoming throughout this inspection. Open visiting is in place to encourage contact with family and friends. Information is available regarding the services offered within the home. Pre admission assessments are taking place and residents and or their representatives are able to visit the home prior to admission. Residents were complementary regarding staff. Staff demonstrated a good knowledge of residents residing within the home. Activities are in place for residents to partake should they wish. The food provided was seen to be nutritious and well prepared. A full and suitable complaints procedure was on display. Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 6 The bedrooms within the newer part of the home were particularly welcoming and well furnished. Communal areas were clean and odour free. The registered manager who is suitably qualified has a keen interest in the training of her staff team. The training of staff to this level can help safeguard residents. Redwood Care Homes Limited supports the registered manager. 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. Redwood House Residential Home DS0000018478.V310203.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 House Residential Home DS0000018478.V310203.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): Standards 1, 3, 4 and 5. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information regarding the service provided at the care home is available to potential residents and their representatives. Potential residents are assessed prior to their admission to ensure that individual care needs can be met. Staff receive training regarding dementia awareness in order to assist in meeting care needs. EVIDENCE: It was noted that a copy of both the statement of purpose and the service users guide were on display in the entrance hall. A copy of the service users guide was sought and supplied by the registered manager. The service users guide is in booklet format and easy to read. The date of issue of this version was December 2006 therefore it does not account for the changes to the Care Homes Regulations, which came into force on 1st September 2006. Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 9 The file of a recently admitted resident was viewed. It demonstrated some areas of good practice in that it was evident that the prospective resident visited the home prior to admission. It was evident that the registered manager undertakes a pre admission assessment in addition some files contained a copy of the assessment carried out by the funding authority. Redwood House is registered to care for up to twenty-six persons who may have a dementia type illness. The care of persons with a dementia type illness is specialised therefore making it necessary for staff to received suitable training in order that care needs can be met. The staff-training matrix demonstrated that the majority of staff attended dementia awareness training towards the end of 2006. The content of this training, which was carried out by the quality assurance manager who is a Registered Mental Nurse (RMN), was not assessed however the registered manager stated that the training was of benefit. Redwood House does not provide intermediate care and has no plans to provide such a service in the foreseeable future. Redwood House Residential Home DS0000018478.V310203.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): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans need to contain sufficient and individual information to ensure that care needs are identified and met. The management of medication needs to be improved to ensure that the systems in place are safe, despite these shortfalls the commission is confident that outcomes are good and that improvements will be made. Staff demonstrated good principals regarding safeguarding residents privacy and dignity EVIDENCE: As part of this inspection a representative sample of care plans, risk assessments and associated documents were viewed. The structure of these documents was discussed with the registered manager at the time of the inspection. The home does not maintain daily notes however records do exist of significant events and carers sign a sheet confirming that the actions detailed on the care plan are carried out. Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 11 Although the actual existence of daily records does not form part of the regulations they are however a good source of evidence to show that care is being provided as detailed within the care plan. Furthermore daily notes can help ensure a consistent approach and good quality of care for residents. A number of older style care plans were seen as well as a style recently introduced at Redwood. It was of some concern that information upon the older style could not be fully captured onto the newer plans. The newer care plans are generic and therefore give a number of options for carers to select. Although the existence of useful reminders and signposts within the care plans has many benefits to ensure that staff consider a range of potential needs and solutions they are not necessarily able to detail the specific details which show each resident as an individual. It was noted that some documents refer to ‘nurses’ however Redwood House is not required to have any nurse qualified staff therefore these documents should refer to ‘carers’. By the time of the second visit the registered manager had reintroduce some of the information upon the older care plans. In addition the registered manager had feed back some additional comments to head office regarding the need for more space on the care plan in order to provide individual information. The majority of care plans were filled out as fully as they could be (taking into account the above comments) although some gaps were evident where by information was not recorded. It was evident that care plans are reviewed on at least a monthly basis although some information or identified care needs were not fully carried out as documented such as the frequency of bathing. During this inspection the management and administration of medication was assessed. It was of some concern that the ‘breakfast’ medication was still being administered when the inspector arrived at the home which was 10.45 a.m. The registered manager stated that the completion of medication administration at 10.45 was not the norm. A prescription was pinned to a notice board for some antibiotic medication which was dated 3 days prior to the first visit of this inspection. The daily records appertaining to the resident confirmed that a doctor had left the prescription in case the resident developed a chest infection. Medication is held in a suitable trolley, which was secured to the wall. It was however of some concern that the key to the trolley was held within a key safe, which was not locked within an unlocked office. The responsible person for each shift must retain the key to the trolley. By the time of the second visit to the home a handover book was in place and the keys were held with the designated person. Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 12 The current months Medication Administration Record (MAR) sheets had commenced a few days before this inspection. As a result a random sample of the previous months sheets were also viewed. Although the majority of MAR sheets were completed satisfactorily a number of concerns were brought to the attention of the manager. A small number of gaps were noted whereby staff had failed to sign for medication given or had not recorded a code to demonstrate why medication was omitted. One gap was noted on a hand written MAR sheet for medication reported to of been given that morning; this was signed for once it became apparent that the signature was missed. It was noted that correction fluid was used on one occasion; this must not be used on records including MAR sheets. This concern was brought to the attention of all senior staff members between the two inspection visits. An audit was carried out on a number of different courses of antibiotics. One course balanced correctly while two did not. On one occasion staff recorded ‘R’ (refused) twice when the audit indicated that the course was complete. On another the transfer of drugs from one sheet to another and the total number of signatures did not match and showed a discrepancy. An audit was also carried out on some painkillers. It became evident that the resident was administered a different amount of medication to the instructions on the MAR sheet which contained staff signatures for medication which was not given. This was of some serious concern because not only had staff signed for medication not given but furthermore it was booked in to the home incorrectly and nobody had noticed the error. Medication not included within the Monitored Dosage System (MDS) had the date of opening recorded upon it. The medication trolley was well organised and tidy. Controlled medication was checked and balanced. It was recommended to the registered manager during the first visit to the home that she discussed with the supplying pharmacy alternative methods of dispensing controlled medication due to the practice of having to handling the drugs on a daily basis in order to count them. The practice was of concern due to possible contamination or potential errors. At the time of the second visit the registered manager was able to evidence that action had taken place. The storage of controlled medication was discussed as the current arrangements do not meet The Misuse of Drugs Regulations (Safe Custody) 1973. The commission strongly recommends that the present storage facilities are reviewed and improved. Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 13 Residents consulted were complimentary regarding the staff at the home. The inspector had no concerns regarding the up holding of resident’s privacy throughout the visits. Staff consulted including the registered manager had a good knowledge of residents care needs; however as demonstrated above this good knowledge was not always evident upon the care plans. Staff observed during the visits to the home were treating residents with respect. Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. Activities are provided to stimulate residents in order to enhance quality of life. Meals served are well presented and nutritious using fresh vegetables where possible to provide a well balanced diet. EVIDENCE: Visitors are able to visit at any reasonable time. Visitors are able to use communal areas such as the lounges as well as residents own rooms as they wish. Residents consulted stated that they enjoy the activities provided including bingo and music and movement. Care plans contained a section on social care needs. A weekly film is shown when residents are served popcorn. Staff undertake activities with residents in additional to their other duties; no activities coordinator is employed. It was noted on the first day of this inspection that the days menu was written upon a chalkboard, however this was difficult to read. It was pleasing to note Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 15 during the second visitthat the registered manager had taken note of this observation and had replaced the chalkboard with a wipe board. On the first day of this inspection the lunch consisted of minced beef, onions, mashed potatoes, carrots, peas and gravy. The afternoon’s tea was detailed as soup, cheese sandwiches and jam. The lunch on the second day was baked gammon and parsley source served with new potatoes, and broad beans. Alternatives consisting of either cheese or chicken salad were available. All six residents consulted about the food provided stated that they were happy with it. Two residents discussed a less traditional meal they had enjoyed a few days before the inspection, upon further consultation it was discovered that this dish was chicken korma. It was reported that a meeting had recently taken place between the cook and resident to discussed items on the menu. The vegetables on the second visit were frozen. The cook stated that frozen vegetables are used on a Monday due to uncertainty as to when the supply of fresh items would be delivered. It was noted that a selection of fresh vegetables for the following couple of days arrived during this inspection. Fresh fruit was available both as part of the available pudding as well as within a fruit bowl. Redwood House Residential Home DS0000018478.V310203.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear and accessible complaints procedure in place. Training has taken place in the past regarding the safeguarding of residents; refresher training may be necessary to further protect residents. EVIDENCE: Redwood has a complaints procedure, which was displayed in the hallway and within the service users guide. The procedure is clear and includes the address of the Worcester office of the commission should anybody wish to raise any matters of concern with the regulator. The registered manager stated that the home had not received any complaints. The commission have not received any complaints regarding the service offered at Redwood since the last inspection visit. The home has a procedure regarding the reporting of adult abuse however this was not viewed on this occasion. A copy of a recently issued booklet issued by the local authority was displayed in the office. The name and contact details of the adult protection coordinator was displayed in both the hallway and within the manager’s office. Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 17 The staff-training matrix evidenced that training regarding the safeguarding of vulnerable adults took place during November 2005. No other training was recorded since the above date although it is accepted that National Vocational Training also includes elements on this subject. The current evidence suggests that further training needs to take place to ensure that all staff have received suitable training as well as any identified updates. Although some shortfalls may exist staff consulted were able to give a satisfactory response when consulted about the action they would take regarding actual or alleged incidents of abuse. Redwood House Residential Home DS0000018478.V310203.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20, 21, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements to the standard of the environment have continued in order to provide residents with a comfortable place to reside where care needs can be met especially in relation to décor in lounge areas. Some refurbishment is needed to provide a more comfortable environment particularly in relation to bathing facilitiesand in some bedrooms. EVIDENCE: The front lounge was in the process of having wallpaper hung on the day of the first visit to the home. This work was completed by the second visit. A number of residents and a relative commented upon the improvement to the décor within the lounges and the dining room. The décor along a ground floor corridor is in need of improvement; it was reported that this is scheduled to take place. This above corridor is narrow Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 19 which would make it difficult for persons to pass one another however improving this would be impractical. The registered providers are currently preparing some new bedrooms on the second floor. These rooms are not yet registered and the provider has not as yet made an application to the Central Registration Team to have these rooms added to the present registration. It was noted that both the lounges contained a radiator, which was uncovered to prevent accidental scalding. The registered manager was not aware that radiators in communal areas should also be suitably covered similar to other areas. In addition to the above radiators one in a bedroom and one in a corridor were also noted to be uncovered. Suitable risk assessments and required action must take place in relation to all the identified radiators and any others not seen during this inspection that remain uncovered. It was noted that motifs are in place on the glass patio doors. Although not fully inspected it was noted that the glass had a British Standards mark on it. The registered person should be mindful of the guidance issued by the Health and Safety Executive regarding low level glazing in care homes. Since the last inspection visit to Redwood House the registered providers have removed the stair lift. This action follows the insulation of a passenger lift to enable residents ease of access to the first floor. Some residents continue to use the staircase; it was noted that it did not have a handrail on both sides. Handrails are not provided throughout the home although it was reported that suitable rails are to be fitted. It was noted that new carpets are fitted throughout corridor areas of the home and reported to be a good improvement. The registered manager assured the inspector that window restrictors are fitted to all windows on the first and second floor. Restrictors are essential to prevent residents either accidentally or deliberately falling from windows above ground floor level. The suitability of these restrictors needs to be continually assessed and monitored. Hot water is thermostatically controlled on baths and on most wash hand basins. Work to fit the remaining wash hand basins and showers with thermostatic controls was in place during this inspection. A random sample of bedrooms were viewed, these included a double room and single bedrooms within the older part of the home as well as bedrooms within the newer wing on the ground floor. Bedrooms within the newer wing were partially attractive; one resident has a small garden outside her bedroom, which was a pleasing touch. All bedroom doors are fitted with a suitable single action lock. Some bedrooms within the older part of the home need to be Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 20 decorated and brought up to the high standard of those within the newer part. Freestanding wardrobes checked were secured as necessary. Screening was in place within a double bedroom. Communal areas consist of two lounge areas and a dining room. The dining room does not currently have sufficient tables and chairs to accommodate all residents at one time. This is currently not a problem as a number of residents choice to eat within their bedrooms. It was noted that the dining room chairs have ‘gliders’ on the feet to make them easier to move. It was reported that some new chairs and occasional tables are on order for the lounge. The majority of communal bathrooms (including a shower room) are in need of refurbishment as they appear dated and lack a welcoming feel conjunctive to quality provision. Residents who wish to smoke may do so in a small corridor area. The laundry was briefly viewed. The home has two washing machines both reported to have a sluice facility. Hand washing facilities are provided within the laundry as required. Staff confirmed that they had access to protective clothing such as disposable gloves. The home was clean and tidy. No offensive odours were detected throughout the visits to the home. Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 21 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): Standards 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Recruitment procedures were found to have some short falls, which could potentially place residents at risk and therefore need reviewing. A review of staffing levels especially leading up to tea time needs to take place to ensure that suitable and sufficient numbers are on duty at all times in order that care needs are able to be met. The number of qualified carers employed within the home almost meets required standard. EVIDENCE: On the day of the first visit of this inspection 3 carers plus the assistant manager were on duty. It was reported that two carers cover the afternoon shift. In addition to carers some younger members of staff are employed over the teatime period to assist with the serving of this meal. It is of concern that at times the rota evidenced that a carer needs to continue with the preparing of residents tea. As a result only 1 carer would be available of meet the care needs of residents. The registered manager stated that she is keen on staff training. A training matrix is maintained showing each employee and training undertaken. The Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 22 majority of mandatory training has taken place although some gaps were noted which need attention. One night carer needs to undertaken moving and handling training. Training is booked for moving and handling as well as infection control over the next few weeks. At the time of this inspection the home had a total of 14 care staff. Out of this number of staff 6 hold either a level 2 or a level 3 NVQ (National Vocational Qualification) therefore just under the required 50 of qualified staff. It was reported that an additional 4 carers are just finishing their training while another 3 are ‘signed up’ to start training. Assuming Redwood House has no staff changes it is evident that the required standard will soon be exceeded. The staff records of two recently appointed employees were looked at. These files were generally satisfactory and evidenced some areas of good practice in relation to recruitment. It was noted that both a PoVA (Protection of Vulnerable Adults) first check and a CRB (Criminal Records Bureau) disclosure are taken up. The application form of one person was held at the home while the other was not. One file showed that although evidence of the obtaining of telephone references was in place only one written reference was held. Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 23 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): Standards 31, 33, 34, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager is suitably qualified and has extensive experience in order to manage the home effectively. The quality systems in place are in place. Some health and safety matters including training need addressing, to fully safeguard residents. EVIDENCE: The registered manager stated that she holds a level 4 NVQ in both care and management as required. Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 24 Both the certificate of registration and the certificate of public liability insurance were on display. Resident’s personal belongings are insured up to the sum of £500.00 (£75.00 for any one item). The organisation has previously confirmed that both a business and financial plan are held at head office, which would be open to the commission, should they be required. It was confirmed that the home does not routinely hold money in safe keeping for residents preferring relatives to carry out this function. Expenditure occurred for items such as hairdressing is therefore invoiced to resident’s representatives if individuals do not pay directly themselves. Redwood group have a system in place within care homes in the organisation to monitor the quality of service provided. A copy of an audit was on display however it was noted that this referred to a 6-month period between September 2005 and February 2006. The document stated that the majority of comments were positive. It was reported that the next survey at Redwood House is due to take place during March 2007. The findings of the forthcoming survey need to be made available to all interested parties including the commission. The quality manager has carried out a review of the service offered at the home. The document applicable to Redwood House was briefly viewed showing some identified shortfalls as well as the actions taken to date. The majority of areas were identified as complying with the required standard. The National Minimum Standards state that care staff receive formal supervision at least 6 times a year. These sessions should cover: all aspects of practice philosophy of care in the home career development needs Although the precise number of supervisions was not audited against each employee it was evident that supervision does take place. These supervision sessions included the following up upon some of the concerns highlighted during the first part of this inspection with staff members. The registered manager is aware of the recent Fire Safety Order, which was introduced on 1st October 2006. As a result of this change in legislation it is necessary for the fire risk assessment to be reviewed to ensure it matches the legal requirement. It was reported that fire training involving all staff had taken place shortly before this inspection; documentation confirming this training was not viewed on this occasion. Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 25 The temperature records regarding ‘fridge and freezers and hot food were completed satisfactory. The storage of items within the fridge appeared to be in line with good food safety standards. It was reported that some minor issued raised by a local Environmental Health Officer were addressed. As highlighted earlier within this report some health and safety training shortfalls were identified during this inspection. It was recommended that the registered manager obtains copies of both the local guidance on infection control as well as guidance issued by the Department of Health. The registered manager confirmed that none of the staff are appointed first aiders as the training provided is first aid awareness. Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 26 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 2 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 2 X X X 2 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 3 3 3 X 2 Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 27 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 OP1 Regulation 5A Requirement The service users guide and if necessary the terms and conditions must be amended in line with recent changes to the regulations. The registered manager must ensure that care plans are sufficiently detailed to ensure that care needs can be identified and met. Medication must be signed for when given. Timescale for action 31/05/07 2 OP7 15 (2) (b) 30/04/07 3 OP9 13 (2) 01/02/07 4 OP9 13 (2) 5 OP25 23 (2) (The previous timescale of 08/11/05 following the previous inspection remains unmet. This requirement must be fully met without delay) The registered manager must 01/02/07 ensure that Medication Administration Record (MAR) sheets are completed correctly and that correction fluid is not be used. The registered manager must 30/04/07 ensure that unnecessary risks to the health and safety of residents including uncovered radiators are identified and as far as possible eliminated. DS0000018478.V310203.R01.S.doc Version 5.2 Page 28 Redwood House Residential Home 6 OP27 18 (1) The registered persons must reviewing and monitor staffing levels in particular leading up to teatime to ensure that care needs are met. 31/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP9 OP38 Good Practice Recommendations It is strongly recommended that a Controlled Drug cabinet which meets the Misuse of Drugs Regulations (Safe Custody) 1973 is obtained. It is recommended that copies of good practice guidance regarding infection control are obtained for reference purposes. Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Redwood House Residential Home DS0000018478.V310203.R01.S.doc Version 5.2 Page 30 - 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. 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