Inspection on 02/06/05 for The Red House

This inspection was carried out on 2nd June 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Red House 23/06/08

The Red House 17/07/06

The Red House 17/10/05

The Red House 18/11/04

The Red House 15/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Red House Bury Road Ramsey Cambridgeshire PE17 1NA Lead Inspector Lesley Richardson Unannounced 02 June 2005 @ 10:00 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 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 I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Red House Address Bury Road Ramsey Cambs PE17 1NA 01487 813936 01487 711504 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) BUPA Care Homes (CFCHomes) Ltd Care Home with nursing 60 Category(ies) of Dementia - over 65 years of age (2) registration, with number Old age, not falling within any other category of places (60) Physical disability (3) Physical disability over 65 years of age (60) The Red House I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two named individual with category DE(E). 2. That the age range of the three residents in the Physical Disability (PD) category is only 60-65 years only. Date of last inspection 18th November 2005 Brief Description of the Service: The Red House is a large converted house and a second purpose built building to the rear, situated on the main road into the market town of Ramsey. It is owned by BUPA Care Homes and provides care and support, including nursing care for up to 60 residents over the age of 65 years. The home has 60 single rooms, all with en suite facilities. Service user accommodation is on two floors in both buildings, the upper floors being accessible by stairs or lift. Fortyseven beds are located in the purpose built premises that were opened in May 1996 and 12 beds are in the older, original house, which was refurbished in 2000. There are a variety of communal areas available to service users, the smaller areas being on the upper floor. The home is set in its own grounds and is a ten-minute walk from Ramsey town centre. The Red House I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 7¼ hours and was carried out as an unannounced inspection on 2nd June 2005. Three and a half hours were spent talking to the manager and examining records and documents. The Inspector looked around the building and spent time with service users and staff. Four people who live at the home and two of the staff on duty were spoken to during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The home needs to keep more accurate care records and write down everything that happens to service users, so that new staff members are able to look after them properly and they are not put at risk. The manager has been appointed by the owners of the home, but an application needs to be sent to the Commission to meet the legal requirement. The Red House I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 Page 6 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 Red House I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Red House I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 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 standard(s) 3 Pre-admission assessment of prospective service users ensures the home is able to meet service users needs. EVIDENCE: Pre-admission assessments were seen in one service user’s file, with copies of social services assessments and information from the transferring care home. The manager said assessments for the other service users had been archived due to the longevity of their stay at the home. Assessments are carried out by the manager or deputy and assessments from other sources are sought to ensure as much information as possible is obtained. The Red House I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 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 standard(s) 7, 8, 9 and 10 The home has a care planning system in place that should provide staff with the information they need to meet service users needs, but care plans had either not been introduced or not been updated to reflect changes in service users needs. EVIDENCE: Individual care plans and risk assessments were available to ensure personal and health care needs were identified and planned for. Most care plans were reviewed on a monthly basis and were re-written when care needs changed; ensuring changes were recorded. However, needs identified in risk assessment and in the daily records of two service users did not have care plans to show the care required to meet those needs. One service user’s care plans were poorly numbered and labelled, making it difficult to see which of the care plans had been reviewed on a regular basis, as there were fewer pages indicating reviews had taken place, than there were care plans. Although most care records gave full dates, not all included the day when entries were made. Recommendation to refer to a healthcare professional in one service user’s plan and recommendations made by a healthcare professional in another The Red House I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 Page 10 service user’s plan had not been followed through. There were no reasons given for why this had not been done. Recording of medication administration is completed accurately and reasons for non-administration of medication documented with a reason for this. Records were up to date at the time of inspection and the trained staff gave a clear explanation of steps for artificial feeding regimes. Service users said care staff were very good, nice and polite. Carers spoke to service users politely and were able to give good examples of how to ensure privacy and dignity was upheld. The Red House I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Social activities provide stimulation and interest for people living in the home, and visits from relatives and friends ensure continued social contact. Meals offer a healthy, varied diet for service users. EVIDENCE: The home has a co-ordinator who organises activities on a daily basis and service users were participating in ribbon bouquet making on the day of inspection. Service users said they had access to the activities and were able to decide whether to attend or not. Newspapers are delivered on a daily basis to one person and there is also a range of books available if service users want them. Day trips and attendance at social clubs is arranged individually or as group outings, and service users said they could have visits from friends and relatives whenever they wanted. The home has started to record service users’ social interests and life histories, but information on the forms seen were very basic and gave only a limited idea of family history and where service users had lived. All the service users who talked to the inspector said the food was good, but one person said it was not quite as good as it used to be, although this person was unable to say exactly what had changed. A choice of main meal is The Red House I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 Page 12 available every day and an alternative can be requested if neither choice is liked. The Red House I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 17 The home had a satisfactory complaints system with evidence that service users were able to confidently raise concerns. EVIDENCE: Service users said they would be able to raise concerns or complain if they felt the need to and were able clearly say who they would approach with different issues. Staff said they were usually approached with concerns service users knew they would be able to resolve, but that service users often raised more general concerns at the monthly residents’ meeting or spoke directly with the manager or more senior staff. One complaint has been investigated by the Commission after the home had completed it’s own investigation. There were a large number of elements to the complaint, of which 10 were upheld; 4 requirements and three recommendations were made following the investigation and the Commission has received an action plan for this. One service user said she had voted in this year’s general election, another service user said she had the opportunity but had not done so. The manager said a total of 18 service users voted this year. The Red House I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The standard of the environment within this home is good, providing service users with an attractive and homely place to live. EVIDENCE: The home was well decorated and maintained, all areas were accessible and safe for service users, with large open communal spaces. It was clean, tidy and all areas were free from offensive odours, including the sluice areas. The laundry was placed well away from the kitchen and dining areas, this area and the sluice areas all had separate hand washing facilities to ensure infection control. The Red House I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Vetting and recruitment procedures ensure that all appropriate checks are carried out, thereby reducing risk to service users. EVIDENCE: Staffing levels in the home were satisfactory on the day of inspection. The home has had some staffing problems in the last few months and has been short staffed on several occasions. However, new staff said the situation had improved since the present manager had started with current staff members staying and fewer short-staffed shifts. Staff files contained most of the information required under Schedule 2 of the Care Homes Regulations 2001, but did not explore gaps in employment, with application forms giving months and years only. Criminal Record Bureau (CRB) and Protection of Vulnerable Adult (PoVA) checks had been completed for all staff members and were locked in the home’s safe to comply with Data Protection requirements. Staff confirmed they had only been employed after a satisfactory CRB check had been returned. Training is given during the induction period for new staff members and all staff undertake mandatory training as required. Staff members said they are reminded of this by a matrix in the staff tearoom that shows when this training is next due. Additional training is given by the manager or deputy manager on a weekly basis, so that all staff members have to opportunity to gain the skills needed to properly look after all service users. The Red House I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 and 36 The home is run in an open manner, thereby enabling it to be run in the best interests of the service users. The arrangements for the supervision of staff is satisfactory with evidence that staff are supported. EVIDENCE: The home does not currently have a registered manager, although there is a manager employed. Staff said since the new manager has been in post the home has become more structured and effective in how staff manage the workload. Service users needs are met in an organised way and staff feel supported and valued. Supervision records were seen for the three months prior to the inspection and identified the core topic(s) discussed and the actions or outcomes but did not go into detail and were not signed by the supervisee. The Red House I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x 2 3 x x x 3 x x The Red House I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 Page 18 NO Are there any outstanding requirements from the last inspection? 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 8 Regulation 13(1)(b) Requirement The home must make arrangements for service users to receive where necessary, treatment, advice and other services from any health care professional. Service users must be consulted about their social interests. An application to register a manager must be submitted to the Commission. Timescale for action 31st July 2005 2. 3. 4. 12 12 13(2)(m) 8(a),(b)(i) 31st July 2005 31st July 2005 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. Refer to Standard 7 7 36 Good Practice Recommendations Care records should be dated with day, month and year for auditing purposes. Care records should detail the effectiveness of care given and be reviewed to reflect changes in service user needs. Supervision records should be signed by the supervisor and the supervisee. The Red House I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 Page 19 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambride CB1 5XE 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 The Red House I53 I03 S24304 RED HOUSE (THE) V229806 020605 STAGE4.doc Version 1.30 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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