Inspection on 20/02/06 for The Red House

This inspection was carried out on 20th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 23/08/07

The Red House 14/09/06

The Red House 24/05/05

The Red House 07/12/04

The Red House 20/07/04

The Red House 19/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Red House The Red House Clonway Yelverton Devon PL20 6EF Lead Inspector Annie Foot Unannounced Inspection 20th February 2006 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 DS0000046280.V258905.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. The Red House DS0000046280.V258905.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Red House Address The Red House Clonway Yelverton Devon PL20 6EF 01822 854376 01822 853331 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) Crocus Care Limited Ms Marlene Treloar Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places The Red House DS0000046280.V258905.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Ms Treloar is provided with 2 weekly supervision by a suitable person within Crocus Care Ltd, and a record of this supervision is kept. Ms Treloar completes the Registered Managers Award by 1st January 2006. 24 May 2005 Date of last inspection Brief Description of the Service: The Red House is owned by Crocus Care Ltd. The home is registered to provide accommodation and care for up to 28 older persons. The Red House is a large detached house set in its own grounds with landscaped gardens. There are commanding views across Dartmoor from many aspects of bedrooms and communal areas. The home is situated in a quiet residential area, on the outskirts of the village Yelverton, near Plymouth. There is a frequent bus service to Plymouth and Tavistock. Yelverton has a number of shops and other facilities. Most of the bedrooms are single with ensuite facilities. There is one double bedroom in the home. The communal lounge, conservatory and other shared areas are light, bright and cosy. It has been agreed that Ms Treloar, the Registered Manager, can extend the time scale for completing her Registered Managers Award to the 30th April 06. The Red House DS0000046280.V258905.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place during the morning of 20th February 2006. It was the second inspection of the year. The manager Marlene Treloar was on duty and present throughout. The purpose of the inspection was to follow up on requirements and recommendation made at the previous visit and to assess progress in other areas. Many of the residents were met and 8 were spoken with. There were four care staff on duty together with the chef and two domestics. They were observed in their duties and spoken with. A visiting district nurse and the activities coordinator were also met. The inspection included a tour of most of the premises, and an inspection of care and medication records. The Registered Manager has been in post for almost 18 months, registered for the last 8 months, and has already begun to manage the home more efficiently. She is enthusiastic about her role and committed to providing a high standard of care. At the same time the manager recognises that there is much more yet to learn and that there are still some changes needed to ensure the home fully meet the standards required and to improve working practices. What the service does well: What has improved since the last inspection? The appointment of a new manager has improved the quality of care provided. Since her appointment the manager has reviewed and implemented new procedures and working practice. She has already made good progress and is keen to develop her skills to ensure that the home provides the best possible care to the residents. The Red House DS0000046280.V258905.R01.S.doc Version 5.0 Page 6 The introduction of a new communication book has improved the record keeping and confidentiality of residents. Fail-safe devices have been fitted to baths. 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 Red House DS0000046280.V258905.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 The Red House DS0000046280.V258905.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): Standards in this section were all inspected and fully met at the last inspection. They were not reassessed on this occasion. EVIDENCE: The Red House DS0000046280.V258905.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): 7,9,10,11 Residents and their families can be reassured by caring practice at the time of death. The systems for storage and administration of medication require review to ensure that residents medication needs are met at all times. EVIDENCE: Staff were saddened by the death of a much loved resident at the weekend. The sensitive way the manager and staff talked about support provided over the past few days, made it apparent that there is a real commitment to provide every possible care up until the time of death. Staff were observed to be respectful toward residents and to call residents by their chose of name. Residents said their privacy and dignity were respected. Systems for care planning and risk assessments have been reviewed. Resident’s files are now split. A working copy is now more easily accessible for staff, while the full file containing initial assessments and full risk assessments are held in the office. The manager reviews care plans and risk assessments monthly. The Red House DS0000046280.V258905.R01.S.doc Version 5.0 Page 10 The Boots MDS system is in place. The pharmacist visits regularly and trains staff who administer medication. Two residents are able to self medicate. Medicines are suitably stored in a locked cupboard. Medicines requiring cold storage are stored in the kitchen fridge. Separate cold storage should be available. Some medications are supplied in blister packs; other forms of medication are stored in open topped plastic containers on a trolley. The names of residents on the outside of trolley trays were not consistent with the named medication. The trolley was extremely wobbly. Staff said a new trolley had been ordered on October 2005 but still had not arrived. Concern was expressed that medications fell off the trolley while wheeling it around the home. A large stock of medications waiting to be returned to the pharmacy was seen in the drugs cupboard. These had been packed in zipped bags. Staff were able to confirm the period of retention for medication after a resident dies. Staff are aware of medication policy but were unable to explain what it contained. Medication records inspected were found to be complete. No specimen signatory list was available and this is recommended. The inspector suggested that arrangements are made for the CSCI pharmacist to visit to advice staff on best practice. A visiting District Nurse was met who said that the home liaises well with the nursing team and always phone is good time should a visit be required. The Red House DS0000046280.V258905.R01.S.doc Version 5.0 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 the following standard(s): 12, 15 The meals are imaginatively prepared and presented with an emphasis of variety and use of fresh ingredients. A nutritious and well-balanced menu with alternatives is offered. A wide range of social activities is offered to meet resident’s interests. EVIDENCE: An imaginative new chef was appointed in December, who has lots of ideas and suggestions to make food and meals more interesting. A four-week menu is in place with alternatives and options always offered at all courses. Lunch on the day of the inspected looked extremely appetising and smelled delicious. Residents said it was very good. There is an emphasis on using fresh vegetables and other fresh ingredients to provide a wholesome and balanced menu. The chef produces different types of homemade cakes every afternoon, including chocolate éclairs, which were said to be “quite delicious”! The chef has lots of ideas to provide something special on the existing functions days e.g. Burns Night, Pancake Day, Valentines and St. Georges Day. Residents said since his appointment the food has improved enormously. Meals are eaten in the communal dining room or in individuals’ rooms. Lunch appeared unhurried with staff on hand to provide assistance. Vegetables are served in separate serving dishes so that residents could help themselves. The Red House DS0000046280.V258905.R01.S.doc Version 5.0 Page 12 There is an activity room in the house. The manager said it was being reorganised. She is keen to provide an active social programme and gave examples of new ideas such as, inviting friends in from community to teaand other events. An in house new letter is produced which keeps residents in touch with what’s going on and invites them to contribute. On the day of the inspection, morning activities were organised by a peripatetic organiser. 7 residents joined in with word, thinking games, and quoits, which everyone enjoyed. The Red House DS0000046280.V258905.R01.S.doc Version 5.0 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 the following standard(s): 16,18 The home has a satisfactory complaints procedure with some evidence that residents feel their views are listened to and acted upon. Recording of complaints must be more consistent to prevent risk to residents. Staff do not fully understand adult protection procedures and have not yet received training. EVIDENCE: A complaints procedure is on display in the dining area of the home. Residents have a copy of the procedure contained with the service user guide. There is a complaints file in place. There had been one complaint since the last inspection. This had not been recorded and was discussed with the manager. Staff and residents were clear about procedures to follow should there be a complaint. The complaints policy needs minor amendments to bring it up to date. Staff are clear about who talk to should a situation of abuse occur but are not fully conversant with procedures. The manager has attended multi-agency training in the protection of vulnerable adults and is developing a training programme for staff based on the DVD “No Secrets”. The manager understands the importance of training in this area and is keen to provide it as soon as possible. There have been no allegations of abuse in the last year. The Red House DS0000046280.V258905.R01.S.doc Version 5.0 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 the following standard(s): 19, 25, 26 Residents are provided with a comfortable and clean environment. Until the programme to fit fail-safe devises to all water outlets is completed, there continues to be a potential risk of scalding to vulnerable and confused residents. EVIDENCE: The home is environment is comfortable and homely. Many aspects of the home have excellent views across Dartmoor and the surrounding area. Two domestic staff are employed. The home was very clean and tidy on the day of the inspection. A handyman is employed to attend to repairs and replacements. Some areas of the home are showing signs of wear and would benefit from redecoration e.g. corridors where corners have been knocked, doorframes adjoining corridors. The manager confirmed that there is a maintenance plan in place and that work is undertaken according to the budget. Since the last inspection fail safe devices have been fitted to bathroom taps. Bath temperatures are recorded weekly. Devices have not been fitted to wash The Red House DS0000046280.V258905.R01.S.doc Version 5.0 Page 15 hand basins. A random selection of water temperatures from basins was checked. These varied from 45oC to over 50oC. In discussion with the manager it was agreed that safety notices would be put up to alert residents to potentially hot water and unregulated temperatures. Separate risk assessments to be undertaken to ensure that residents are safeguarded from any risk of scalding until work to fit devices to all taps is completed. The Red House DS0000046280.V258905.R01.S.doc Version 5.0 Page 16 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): 27, 29,30 There are good arrangements for the induction of new staff. Staff are able to demonstrate a clear understanding of their role. EVIDENCE: There were 4 care on duty, sufficient to meet the needs of residents. Positive interactions were observed between residents and staff. Staff spoken to were clear about their roles and responsibility. Staff said they work together as a team, but were finding it difficult with high levels of staff sickness and vacancies. An agency member of staff was working her first day at the home. One resident expressed concerned about the length of shift staff work. A new member of staff was able to explain the induction process and programme. They felt that they had received adequate information to be able to do the job. Induction is undertaken over four half days and includes shadowing an experienced staff member. In addition new staff complete the TOPPS induction programme. Training records were examined which showed that staff receive statutory training. Training in the understanding of Continence is also provided and in the safe handling of medication (through Boots). There is no annual training programme in place and this was discussed with the manager. The Red House DS0000046280.V258905.R01.S.doc Version 5.0 Page 17 The Red House DS0000046280.V258905.R01.S.doc Version 5.0 Page 18 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, 32,35,38 Resident’s and staff benefit from an enthusiastic and committed manager with a good understanding of meeting older peoples needs. Resident’s benefit from and open and inclusive ethos toward management of the home. Systems are in place to safeguard residents financial interests, although some procedures need to be reviewed and clarified. EVIDENCE: The registered manager has been in post for almost eight months. She has been employed by the home for three years, initially starting as a care assistant and working her way up to deputy manager before taking on the managers role. She is currently undertaking the Registered Managers Award, which she hopes to complete by the end of April 2006. This date has been extended due to sickness and changes in the assessor, and is a condition of registration. The Red House DS0000046280.V258905.R01.S.doc Version 5.0 Page 19 The manager describes her style as open and approachable. She recognises that she is on a steep learning curve and has more to learn. She aims to provide “a guest house for elderly people” rather than institutionalised care and encourages staff to spend time talking to residents. She knows residents well and spends time with them each day. The manager is committed to welfare of residents and described how she came into the home during her leave to spend time with a dying resident. The manager confirmed that she is well supported and supervised by the Director of the Company Clare Hunter. Staff describe the manager as approachable and supportive. One staff member said the manager was “in touch with what’s going on in the home”; another said she was “very supportive”. Resident’s monies are stored securely in a locked cabinet. The manager described the processes taken when receiving money for residents. It was noted that receipts were not given to families who handed over cheques. All other financial transactions are recorded. Records were up to date. While none of the resident’s monies are pooled it is not clear into which bank account personal cheques are paid. This should be checked to confirm that resident’s monies are not paid into a business account. Health and safety standards were not inspected on this occasion. However a range of miscellaneous toiletry item were seen in bathrooms. These should be removed to prevent risk of cross infection. The Red House DS0000046280.V258905.R01.S.doc Version 5.0 Page 20 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 3 8 x 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 x 18 1 3 x x x x x 1 3 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x x 2 x x 2 The Red House DS0000046280.V258905.R01.S.doc Version 5.0 Page 21 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 OP9 Regulation 13 (2) Requirement Arrangements must be made to replace the medicine trolley to ensure that medications are safe and do not fall off the trolley. Medicines that are not supplied in blister packs must be stored securely. To ensure that all complaints whether verbal or written are thoroughly investigated and recorded. To provide staff with training in the protection of vulnerable adults. The registered provider must ensure that all hot water outlets, accessible to residents are fitted with fail safe devices, and hot water regulated to 43oC as required. Timescale for action 01/03/06 2 3 OP9 OP16 13 (2) 22 (3) 01/03/06 01/03/06 4 5 OP18 OP25 13 (6) 13 30/04/06 30/04/06 The Red House DS0000046280.V258905.R01.S.doc Version 5.0 Page 22 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 Refer to Standard OP9 OP9 OP9 OP9 OP16 OP30 OP35 Good Practice Recommendations Staff responsible for the administration of medication should be reminded of the content of the medication policy. A drugs fridge should be obtained to store drugs requiring cold storage. To obtain a copy of the Royal Pharmaceutical Society Guidelines for the Administration and Control of medicines in care homes. www.rpsgb.org.uk Tel: 0207 572 2409 To compile a list of specimen signatures and initials to be held with medication records. To review the complaints procedure and up date information to ensure consistency. To develop and annual staff training programme to ensure all staff attend regular training. To establish a system for receipting cheques received on behalf of residents. To confirm that no personal monies are paid into a business account. To remove miscellaneous toiletry items from bathrooms to reduce the risk of cross infection. 8 OP38 The Red House DS0000046280.V258905.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 DS0000046280.V258905.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!