Inspection on 27/06/05 for The Red House

This inspection was carried out on 27th June 2005.

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 11/03/07

The Red House 07/03/06

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 Jon Potts Unannounced 27 June 2005 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 E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Red House Address 8 The Village Kingswinford West Midlands. DY6 8AY 01384 291757 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) Mr. David ODonnell Mr. David ODonnell Care Home 8 Category(ies) of OP Old Age (8) registration, with number of places The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered to 8 older people whose primary needs are due to old age with one of these places registered for an older person whose primary need can be due to mental disorder. The home is not registered for nursing care and as such any nursing service would be provided by community helalthcare services where appropraite (for example - district nurses). There are no other conditions of registration. Date of last inspection 28/2/05 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 accomodation 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 accomodation, but has on occassions offered some short term care. Emergency care maybe provided dependent on individual circumstances The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector drew evidence from a number of sources that included case tracking the care provided to three residents this involving examination of all their care records. Other records examined included policies/procedures, staff records and training records. There was discussion with two residents and six relatives and friends of residents. There were also comments received from residents, relatives and a G.P. through CSCI comment cards. The residents, relatives spoken to and the providers are to be thanked for their assistance with this inspection. What the service does well: 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 The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 Page 6 contacting your local CSCI office. The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 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 E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 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) 3,4 Staff are fully aware of the steps to take prior to admission of any resident . The home meets the needs of the residents accommodated. EVIDENCE: The home has a statement of purpose and service user guide that has been seen by the inspector on previous visits. There have been no new admissions to the home since the last inspection, this meaning that there is no current and up to date evidence of the home complying with standards in respect of admission although the registered provider/manager is known to be fully aware of these. There were copies of social workers assessments for those residents’ case tracked (where funded by social services) and more recent evidence of the home requesting reviews from social workers, these documented where having been carried out. Based on the comments received from residents and relatives the home is meeting the formers needs, this further confirmed by the comments from one of the General Practitioners that visit the home. The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 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 The resident’s needs health, personal and social care needs are set out in individual plans of care that are in most cases accurate. Residents healthcare needs are met in accordance with their individual choices Residents are protected by the homes systems for the administration, storage and control of medication. EVIDENCE: All the case files examined carried copies of a care plan these containing details of the needs of the residents whose care was tracked. These plans contained basic details of the care the home was to provide which in most cases was found to be accurate although there was some limited instances where further information needed to be detailed to ensure that the plans were up to date and fully accurate. The plans were seen to be reviewed six monthly at present, these in-house reviews needing to be done monthly as a minimum. Some of the plans were seen not to carry any signature of the resident or their representative to show that they agreed with and had seen their individual plan. There was however clear evidence of the residents having appropriate access to community health care services where wished. The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 Page 10 Sampling of the homes systems for the administration, storage and control of medication showed the homes last pharmacy audit to be accurate in identifying no areas of concern. Staff are in receipt of accredited medication training. The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 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, 15 The residents have access to a lifestyle in keeping with their preferences and expectations. The home is accessible to relatives/ friends and representatives of the residents. Residents have access to foods and meals that are in keeping with their expectations, most of the time. EVIDENCE: Those residents spoken to were clear that they were able to make choices as to when to rise, go to bed, where to spend their time and how. There were only six residents in the home at the time of the inspection and through discussion with two and responses through CSCI comment cards from another three, four of the residents felt that there was appropriate activity and two only sometimes. The residents spoken to did have opportunity to partake of individual activities but did prefer to have a sedentary lifestyle and were clear that they chose to remain in their bedroom (in each others company). In summary the home does not offer a great deal in formal activity but this would appear to be, overall, in keeping with the current residents preferences. The manager /provider was advised to keep this matter under review. Discussion The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 Page 12 with a number of visitors to the home evidenced that they were made welcome, offered hospitality, and able to see their relatives/friends in private. The home was seen to have a policy on maintaining relatives involvement, this to be given to relatives when any new resident is admitted to the home. Comments in respect of the homes meal/food provision indicated that the majority of residents were satisfied with this with only one stating out of five that they like the food sometimes. It was stated by two residents that food was always available and by one that it was ‘wonderful’. There was some comment that the bread was sometimes too thick to eat (this on two occasions). The manager/provider was made aware of this matter at the time of the inspection. Discussion with a relative evidenced that the diet for a resident that had difficulty with solids was appropriately prepared and was also made to look as appetising as possible. The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 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, 18 Residents or their representatives are aware of the homes complaints procedures and know how to make a complaint. Residents feel that they are ‘safe’ at the home. EVIDENCE: The home was seen to have an appropriate complaints procedure in place and all the residents and relatives that were spoken to were aware of the homes complaints procedure or what action to take if they were dissatisfied in any way. One of the relatives spoken to stated that they felt able to raise any concerns that they may have directly with the management of the home, and was sure that these would be dealt with appropriately. The home was seen to have appropriate procedures in place in respect of adult protection, this including the local authorities procedures. All the residents spoken to and responding to the CSCI survey indicated that they felt safe at the home. The staff are yet to have bespoke training in adult protection/dealing with abuse but this was stated to be arranged for the 30.7.05 by the provider. The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 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) 19,26 The Red House presents as a comfortable and homely environment that is well maintained. The home is kept clean and hygienic. EVIDENCE: The Red House presents as a comfortable and homely environment and was seen from sight of a number of areas in the home to be well maintained and decorated. The home has received inspections from both the fire service and environmental health in the recent past, this giving rise to a small number of recommendations (as opposed to legal requirements), some of these seen to have been addressed. The only work that needed to be addressed was a joint in the carpet by the kitchen that was presenting a tripping hazard, the manager/provider stating that they were looking to replace this carpet in the near future. The loose edge does need securing in the meantime however so as to make safe. The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 Page 15 The home has appropriate procedures in place in respect of infection control and the home was seen to be clean with no odours present. Residents and relatives also commented on the cleanliness of the home and that fact that there were never any odours present. Staff have completed distance-learning training in infection control and are awaiting their certificates as confirmation of their achievement. The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 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 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, 28, 29, 30 Sufficient and experienced staff meet the needs of the residents. There are some minor omissions in the homes current recruitment practices that may compromise resident’s safety. Staff competence and knowledge would be enhanced through further vocational training. EVIDENCE: There was sufficient staff available at the time of the inspection, although duty rosters were not looked at as discussion with residents and relatives indicated that there were no immediate concerns in respect of staffing levels. As the home is a small unit the manager/provider and partner are very involved in the delivery of care. The home was seen to have minimal staff turnover. The inspector examined the staff file for the last member of staff that was employed by the home to check on recruitment practices. All the expected checks, information was found to be in place with the exception of the employee’s full working history (the application form not containing space for this) and a reference from the last employer. The manager/provider was aware of the need to obtain a POVA 1st check prior to employment of any staff with a risk assessment completed if these staff were employed prior to the receipt of their enhanced disclosure. There was evidence of the staff member having undertaken an appropriate induction to nationally recognised standards The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 Page 17 There was also clear evidence of the staff receiving on – going training input with recent training over the last 12 months or so including moving and handling, food hygiene refreshers, safe handling of medication, health and safety and infection control. There was evidence of staff having received training in other areas prior to the above. A third of the staff team hold an NVQ level 2 this meaning that further NVQ training needs to be provided so as to enable the home to have above the expected 50 ratio. The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 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 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) 31,36,38 The home is run by a manager and staff that the residents have confidence in, and staff are appropriately supervised. Staff are trained in, and carry out safe working practices. EVIDENCE: The manager is also one of the homes joint owners and has managed and worked at the home for numerous years. It was evident from discussion that he was well abreast of current developments in the social care field and had a good knowledge of what comprised good care for older people. This was reflected in some of the comments from the residents spoken to who held him in high regard, as they did the staff in general. The manager/provider has a qualification that would be comparable to the management component of NVQ level 4 but does need to formalise his care skills through this type of training framework. The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 Page 19 There was found to be clear evidence of on going documented formal supervision of the staff employed at the home. There were no concerns in respect of safe working practices at the time of this inspection beyond the comment in relation to the carpet joint (see earlier in this report). The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 2 x x x x 3 x 2 The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 Page 21 yes 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 7 Regulation 15 Requirement The care plans must be reviewed monthly and reflect any changes to the care provided as they happen The care plans must also be signed by the resident and/or their representative to evidence their awareness of the plan. The residents views on activities available within the home must be kept under review. There must be regular consultation with residents as to the type of bread they prefer. The registered provider must ensure that all staff receive adult protection awareness training. This is a repeated requirement. The date stated is the one on which the training is planned by the home. The joint in the carpet in the hallway by the kitchen must be secured so that no tripping hazard is presented. There must be at least 50 of the staff team qualified to NVQ level 2 in care or above. E55 S25041 The Red House V236305 270605 Stage 4.doc Timescale for action on-going 2. 3. 4. 12 15 15 14 & 16 12 & 16 13(6) on-going on-going 30/7/05 5. 19/38 23 immediate. 6. 28 18 31.12.05. The Red House Version 1.40 Page 22 7. 29 19 The following information must be obtained prior to employment of any new staff: Details of the applicants full working history with explanation of any gaps in employment: A written reference from the last employer. The manager of the home must have a qualification relevent to the care provided in addition to the management qualification already held. From the point at which new staff are recruited 8. 31 9 31.12.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 13 Good Practice Recommendations To ensure that relatives have a copy of the homes visiting policy at the point a resident is admitted to the home. The Red House E55 S25041 The Red House V236305 270605 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection West Point Mucklow Office Park Mucklow Hill Halesowen. B62 8DA 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. 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