CARE HOMES FOR OLDER PEOPLE
Redwood House Residential Home 11 Cherry Hill Road Barnt Green Worcestershire B45 8LL Lead Inspector
C Presley Unannounced Inspection 8th November 2005 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 House Residential Home DS0000018478.V258379.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Redwood House Residential Home DS0000018478.V258379.R01.S.doc Version 5.0 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 Limited 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.V258379.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 11th July 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 a stair lift, but is planning to upgrade the building and this will include the provision of a passenger lift. 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 are ensuite and two double bedrooms one of which is ensuite. 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 care manager Mrs Nicola Hill is responsible for the day-to-day management of the home. A Director of the company is also on site every day as their head office is located on the second floor of the building. Redwood House Residential Home DS0000018478.V258379.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place during the morning and over breakfast time. Time was spent inspecting policies and procedures, talking with residents, staff and the registered manager. This inspection focused on requirements from the last inspection visit and standards not inspected last time. What the service does well: What has improved since the last inspection? What they could do better:
The Home needs to continue the refurbishment programme and communal areas require new carpets. A fire door was not closing on its rebate this has been noted on a number of occasions. Redwood House Residential Home DS0000018478.V258379.R01.S.doc Version 5.0 Page 6 On checking medication sheets there were a number of signature gaps and an excess of medication, which the registered manager had locked away from the drug trolley for safety. 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.V258379.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Redwood House Residential Home DS0000018478.V258379.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards were inspected in this section of the report for further information refer to previous report. EVIDENCE: Redwood House Residential Home DS0000018478.V258379.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 & 10 Medication policies and procedures are followed, this ensures medication is administered safely and residents are not put at risk. EVIDENCE: Medication charts were inspected it was noted that there were a number of signature gaps, the registered manager explained this was due to the new Nomad cassettes of medication being delivered that morning. There was an excess of a medication, which required urgent return to the pharmacist. The antibiotic for one resident was not given a specific name and had not been countersigned by two staff. Controlled medication was appropriately stored. The medicines policy was up to date and the home had a policy for homely remedies, which was in date. Residents are encouraged to receive visitors and there are private areas in the home to receive visitors. Staff were observed to be speaking kindly to residents.
Redwood House Residential Home DS0000018478.V258379.R01.S.doc Version 5.0 Page 10 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): 14 & 15 Residents are offered a nutritious and appealing diet; residents choose where they eat their meals and meal times are unhurried. EVIDENCE: The kitchen has been completely refurbished and requirements following the Environmental Health Officer’s visit have been fully addressed. A fresh order of vegetables was delivered during the inspection and menus showed a varied and appealing diet. Residents were able to choose where they ate their meals and support for those who needed assistance, was given in a dignified manner. Records of food, fridge and freezer temperatures were in order. A record of food given to residents was kept. Residents were encouraged to take care of their own personal monies and possessions if they were able and lockable storage space was provided in all bedrooms. Extras were invoiced to the next of kin; the home did not have any facilities for storage or safekeeping of monies for residents. Redwood House Residential Home DS0000018478.V258379.R01.S.doc Version 5.0 Page 11 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): None of the standards were inspected in this section of the report for further information refer to previous report. EVIDENCE: There have been no complaints to the home or to the Commission for Social Care Inspection since the last visit. Redwood House Residential Home DS0000018478.V258379.R01.S.doc Version 5.0 Page 12 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): None of the standards were inspected in this section of the report for further information refer to previous report. EVIDENCE: The home has commissioned three new bedrooms, which are now registered, with the Commission. There is ongoing building work and refurbishment and plans for a passenger lift to replace the stair lift are due to commence in 2006. Redwood House Residential Home DS0000018478.V258379.R01.S.doc Version 5.0 Page 13 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): 29 & 30 Recruitment procedures are robust and staff are screened before commencing work in the home to make sure they are safe to do so. EVIDENCE: Recruitment files checked evidenced there was a robust recruitment procedure followed including a POVA first and criminal record checking at enhanced level before staff were employed in the home. Staff had an induction programme, which underpinned some of the core units of NVQ, most staff did not require a TOPSS foundation course as they commenced NVQ training once the induction programme was completed. Fifteen care staff were employed and of these ten staff had an NVQ qualification in direct care and one member of staff was starting shortly. Staff training was a priority and was continually monitored by the registered manager to ensure staff kept their training up to date. Redwood House Residential Home DS0000018478.V258379.R01.S.doc Version 5.0 Page 14 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 The registered manager has the experience and knowledge to run the home and ensures that residents are given the opportunity to live as full a life as possible within the limitations of their illnesses. EVIDENCE: The registered manager has the knowledge, experience and training to run the home well. There is a stable workforce in the home and residents are well cared for in a homely environment. The home has an excellent quality assurance audit programme where residents and other visitors to the home views are taken into consideration. Records of furnishings belonging to residents are kept, and all bedrooms have lockable storage space. Keys are offered to residents for their bedrooms within a risk framework.
Redwood House Residential Home DS0000018478.V258379.R01.S.doc Version 5.0 Page 15 It was noted the bath hoists did not have a maintenance contract and this has become an urgent requirement of this report. Redwood House Residential Home DS0000018478.V258379.R01.S.doc Version 5.0 Page 16 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X X Redwood House Residential Home DS0000018478.V258379.R01.S.doc Version 5.0 Page 17 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 2 Standard OP9 OP9 Regulation 13 (2) 13 (2) Requirement Medication must be signed for when given Medication if hand written must state the name of the drug and must be countersigned by two staff Excesses of medication must be returned to the pharmacist and there must be an audit trail with quantities supplied and returned Fire doors must close on rebates Bath hoists and free standing hoists must be maintained and serviced at least every six months Timescale for action 08/11/05 08/11/05 3 OP9 13 (2) 08/11/05 4 5 OP19 OP38 23 13 08/11/05 08/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Redwood House Residential Home DS0000018478.V258379.R01.S.doc Version 5.0 Page 18 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
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