Inspection on 11/03/07 for The Red House

This inspection was carried out on 11th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

The Red House 06/03/09

The Red House 07/03/06

The Red House 27/06/05

The Red House 28/02/05

The Red House 05/11/04

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

CARE HOMES FOR OLDER PEOPLE The Red House 8 The Village Kingswinford West Midlands DY6 8AY Lead Inspector Mrs Mandy Beck Key Unannounced Inspection 11 March 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 The Red House DS0000025041.V325219.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. The Red House DS0000025041.V325219.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Red House Address 8 The Village Kingswinford West Midlands DY6 8AY 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) 01384 291757 01384 291757 davidjodonnell@hotmail.com Mr David John O`Donnell Mrs Shirley Nita O`Donnell David O`Donnell Care Home 8 Category(ies) of Dementia - over 65 years of age (1), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (6) The Red House DS0000025041.V325219.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7 March 2006 Brief Description of the Service: The Red House is a 200 year old Grade 2 listed building sited in the centre of the original Kingswinford village, immediately in front of the local church. The building has been extended and adapted for its present use. The home is easily accessible from the main Kingswinford to Dudley Road but is set in tranquil and picturesque surroundings. The residents accommodation is provided on the ground and first floors the latter accessible by a shaft lift. The registered providers (one of whom is also the registered manager) live on site and are very involved in the day-to-day service provision. There are four single bedrooms and two shared rooms, some of these having en-suite facilities. Communal areas available include a dining and sitting area, these very domestic in their presentation. The home has a small staff group, members of which have worked at the home for a number of years. The main aim of the home is to offer family style living and personal care in a small homely unit for older people of either gender. The home offers mostly long stay accommodation, but has on occasions offered some short term care. Emergency care maybe provided dependent on individual circumstances The home currently charges between £335 and £355 per week for residency, this does not include extra services such as chiropody an hairdressing. Service users will be charged for these services. The Red House DS0000025041.V325219.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and lasted for 5 hours, during this time evidence was gathered and has been used to make the judgements in this report. Service user files were looked at as part of the case tracking process. This process requires the inspector to look at individual service users plans and to make sure that home is meeting their needs. Some staff files were also looked at to make sure that the home is recruiting staff safely and safeguarding service users. Information has also been provided to the CSCI from the manager in a pre inspection questionnaire. Service users were also asked for their views using our comment cards. The comments have been included in the report. Time was also spent talking to the manager and the service users. The inspector would like to thank all of the staff and service users for their hospitality throughout the inspection. What the service does well: The home is very welcoming and provides a relaxing environment for service users to live in. The staff group are experienced and have a clear understanding of the service users needs. “The staff are lovely and very caring”, “ I am very content here, David makes sure we are looked after” Service users commented that the food is always very nice, “ the food is nice and always cooked well, I don’t think there is nothing I don’t eat”, “There’s always plenty to drink”. “If I don’t like what’s on the menu they always make me something else”. The Red House DS0000025041.V325219.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. The Red House DS0000025041.V325219.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 The Red House DS0000025041.V325219.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): 3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be assured that their needs will be assessed before they agree to move into the home. They can expect the home to be able to meet their needs. EVIDENCE: Service users can feel confident that before they agree to move into the home, they will have their needs assessed. The manager will also confirm this in letter to the prospective service user. Two service user files were seen as part of the case tracking process. It was pleasing to see that both of the files contained an assessment of need, there was evidence that service users had been involved in this process from the beginning. The completed needs assessment then forms the basis of care planning for each individual service user. The home does not provide intermediate care. The Red House DS0000025041.V325219.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can feel confident that their needs will be met and that they will receive the health care they need. Service users will be treated with respect and dignity at all times. EVIDENCE: Each of the files seen contained a detailed plan of care. This also included various risk assessments that indicate when a service user is a risk, such as pressure sore risk development, falls, moving and handling and malnutrition. The manager has improved the care planning process since the last inspection. Service users are now demonstrating their involvement by signing their care plans to indicate their agreement with the contents. Care plans are being reviewed regularly to reflect changes in need. In addition to this GP’s and the district nursing service support the home and visit service users regularly. Service users were generally happy with the level of care they receive there were some comments of dissatisfaction that the home should address. One service user commented “I have only received one The Red House DS0000025041.V325219.R01.S.doc Version 5.2 Page 10 visit from the Doctor in the last year that I’ve been here”, “the manager will check me first to see if he thinks the doctor should be called”, whilst others stated “the Doctor comes as soon as they call him”. Medication practices in the home are generally good but improvements could be made to the safe keeping of medication that requires cold storage and the controlled drugs. The home does have a medication policy to instruct staff how to administer and handle service users medication safely. It is also using guidance from the Royal Pharmaceutical Society of Great Britain. The inspector has consulted with the CSCI’s Specialist Pharmacist Inspector about this matter and professional guidance has been issued to the manager and requirements made in this report. All of the service users agreed that the staff at the home treated them with respect and dignity. They said “the staff are lovely”, “I’m very content here David and his wife make sure we are looked after”, “I’m never rushed they always have time for me”. There were other comments “sometimes I forget what to do they help me a lot”, “I need help with washing they tried to rush me but I asked them to slow down and they did, things are much better now”, “I would like a shower a bit more often it can be four weeks before I get one”. The Red House DS0000025041.V325219.R01.S.doc Version 5.2 Page 11 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): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are encouraged to maintain their family contacts and to take part in activities if they choose to do so. Service users are assured of a balanced diet that meets their needs. EVIDENCE: The manager stated that there is no formal activity programme for the home, but service users are encouraged to spend their time as they choose. Some of the service users spend their time in their rooms and are content to do so. “I prefer it here because this is where all my things are and it’s comfortable”. Others prefer to spend time in the lounge watching the television, during the inspection service users were watching Murder she Wrote, stating “this is my favourite”. One service user said “we used to go out but to be honest we are happy spending time in the home now” The home has two pet dogs Noodles and Suzi, service users commented “they’ll bite you if they don’t like you”, “I love them they sit on my lap they are playful”. The inspector didn’t see the dogs during the inspection care staff made sure that they were kept in a separate room. The Red House DS0000025041.V325219.R01.S.doc Version 5.2 Page 12 Visitors are encouraged at anytime during the day but they are asked to give consideration to service users needs early evening and morning time. Meals are freshly prepared on the premises. There is a menu but this is not usually adhered to, as service users tend to change their mind. On the day of the inspection service users had salmon and parsley sauce with vegetables and potatoes, another service user had a bacon sandwich. “The food is lovely you know” “we also get plenty to drink”. Meals can be served in service users own rooms, the dining room or the preferred choice for some service users, on a tray in the lounge so they can watch the television. “I like my cup of tea in front of the telly”. The Red House DS0000025041.V325219.R01.S.doc Version 5.2 Page 13 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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be assured that their views will be listened to and acted upon. Service users are protected from abuse. EVIDENCE: The home has received no complaints in the last twelve months. The policy remains unchanged and the manager deals with complaints in an informal manner. Service users are encouraged to talk about anything that is making them unhappy. One service user said “I am unaware of how to make an official complaint although the need has never arisen”. All of the staff had training in adult protection, this was over two years ago and refresher training is now due. This will reinforce the staff’s knowledge and skills in dealing with adult protection issues. The home does have the local authority guidance and the manager must ensure that when staff have their training that this guidance is included in it. There have been no adult protection referrals since the last inspection. And it was pleasing to hear that service users felt safe in their environment. “I am very glad I came here, they make us feel safe you know, I wasn’t at home”. The Red House DS0000025041.V325219.R01.S.doc Version 5.2 Page 14 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): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and provides a cosy environment for service users EVIDENCE: The home is generally well maintained. It offers a very welcoming and cosy environment for service users to live in. Since the last inspection new carpets have been laid in the hallways and there are plans to replace more carpets in the coming year. Outside the building needs attention and the manager stated that as soon as the weather is better painting would be started. The manager and his wife are the registered providers for the home and they also live on the premises. There is a small laundry and it is well equipped, there are good systems in place to reduce the risk of cross infection to all service users. The Red House DS0000025041.V325219.R01.S.doc Version 5.2 Page 15 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be assured that staff will provided inadequate numbers to meet their needs and that they will be recruited in a way that protects their wellbeing. EVIDENCE: The manager and his wife are the registered providers for the service, they also live at the home. This means that they are able to support staff in their duties 24 hours a day. Staffing levels are adequate and at present meet the needs of the service users. There are usually two care staff plus the manager on each shift to assist service users. The home has a very stable staff group. Since the last inspection one new member of staff has been employed. The file for this person was examined to make sure that all of the required information had been obtained prior to their employment. It was pleasing to see that all the required safety checks such as a PoVA and CRB disclosure had been completed. there were a few minor shortfalls that the manager is in the process of addressing such as a recent photograph of the worker. New workers are given the opportunity to undertake a comprehensive induction programme. This programme meets the Skills for Care Standards and offers the new worker a complete introduction to social care. The Red House DS0000025041.V325219.R01.S.doc Version 5.2 Page 16 Other staff receive regular supervision throughout the year and once a year the manger completes an annual appraisal with them, this gives the worker the chance to identify any training issues they may have. At present only one of the five staff employed has completed their NVQ level 2 training, this was an outstanding requirement from the previous inspection. The manager stated that he is hopeful that another member of staff will complete this training in the near future. The Red House DS0000025041.V325219.R01.S.doc Version 5.2 Page 17 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): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a well run and well managed home. EVIDENCE: The manager Mr David O’Donnell is currently undertaking his NVQ level 4 in care training and is hopeful that this will be completed in the near future. He has run the home for 18 years. Throughout the inspection service users stated that Mr O’Donnell would do anything for them, and that they “couldn’t have a better person looking after us”. The home has a detailed quality assurance system in place, annual audits are completed but more work needs to be undertaken in determining service users views about their experience of living at the home. Relatives and other interested parties such as GP’s and District nurses should also be consulted so that the home can be sure that it is acting in the best interests of the service The Red House DS0000025041.V325219.R01.S.doc Version 5.2 Page 18 users at all times. The manager stated that he does this already but the process isn’t formalised and there are no notes to support this. It was suggested that formalising the process would demonstrate how the home includes service users in their quality assurance process. The manager told the inspector that the home does not handle any of the service users money. The service users families or the Court of Protection deals with all finances. Therefore this standard was not assessed. The home is well maintained and some of the safety certificates were “spot checked” to ensure that they were up to date. It was pleasing to see that everything was in order. The manager keeps regular checks on the environment and maintains appropriate records. Some of the staff training in first aid, moving and handling, infection control and health and safety is due to be refreshed this year to ensure staff knowledge is kept up to date with changes in legislation and current best practice. The Red House DS0000025041.V325219.R01.S.doc Version 5.2 Page 19 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 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 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 2 X 2 X N/A X X 3 The Red House DS0000025041.V325219.R01.S.doc Version 5.2 Page 20 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 OP9 Regulation 13(2) Requirement Medication stored in the fridge must be kept in a locked container inside the fridge, keys held by the person in charge There must be at least 50 of the staff team qualified to NVQ level 2 in care or above. This is a repeated requirement that was to have been met by the 31.12.05. Timescale for action 01/06/07 2. OP28 18 01/06/07 The Red House DS0000025041.V325219.R01.S.doc Version 5.2 Page 21 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 3 4 5 6 7 8 Refer to Standard OP7 OP8 OP9 OP9 OP18 OP26 OP31 OP33 Good Practice Recommendations It is recommended that risk assessments for service users be reviewed on a monthly basis. It is recommended that service users see their own GP at their request. It is strongly recommended that controlled drugs should be stored according to the Misuse of Drugs (safe custody) Regulation 1973 It is strongly recommended that separate CD records are kept in a separate bound book with numbered pages. It is recommended that all staff have Adult Protection training every two years. It is recommended that the manager obtain a copy of the Department of Health guidance “infection control guidance for care homes” June 2006 For the registered manager to complete his NVQ level 4 in care qualification. To date on the quality assurance record when an audit of a set standard is carried out and to consider consulting with all stakeholders on an annually basis (this to include such as district nurses, G.P s, opticians etc). The Red House DS0000025041.V325219.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 The Red House DS0000025041.V325219.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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