Inspection on 29/09/05 for The Red House

This inspection was carried out on 29th September 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 24/11/08

The Red House 15/12/06

The Red House 12/04/05

The Red House 20/09/04

The Red House 29/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE The Red House Norwich Road Kilverstone Thetford IP24 2RF Lead Inspector Jerry Crehan Announced 29 September 2005 9.30am th 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 I55 s32102 redhouse v240021 290905 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Red House Address Norwich Road, Kilverstone, Thetford, Norfolk, IP24 2RF 01842 753122 01842 760337 rclaxton@totalise.co.uk Miss Rachael Claxton 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) Miss Rachael Claxton Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places The Red House I55 s32102 redhouse v240021 290905 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 12th April 2005 Brief Description of the Service: The home is registered to provide accommodation and personal care to up to 14 older people. It is not registered to deliver nursing care. It is situated set back from a main road out of Thetford, near to a large supermarket. There is a gravel driveway to the main door of the home, with parking to the side and rear. The grounds are extensive, but parts are not easily accessible. Service users can access the garden, lawns and patio to the front of the home. Accommodation is provided in two main areas, leased by the registered proprietor. The older part of the home is on two floors, with bedroom accommodation on the first floor. There is assisted access via a stair lift. Communal areas (lounge and dining facilities) are provided in the ground floor. An extension provides additional ground floor bedrooms. The Red House I55 s32102 redhouse v240021 290905 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 6.5 hours. Opportunity was taken to tour the premises, look at care records and policies, and communicate with many of the 13 service users in addition to visiting relatives, staff and the manager. As no comment cards were received prior to the inspection, the manager is advised to consider ways in which comment cards can be better promoted to relatives and others. What the service does well: What has improved since the last inspection? What they could do better: Care planning is generally good at the home, however are not (in every case) supported by clear information for staff to follow. Care plans or risk assessments need to set out in clearer detail for care staff how they should deal with relevant aspects of care. The Red House I55 s32102 redhouse v240021 290905 stage 4.doc Version 1.40 Page 6 The home’s staff supervision programme must be reinstated immediately, after a lapse as a consequence of recent staffing turnover. Recruitment practices at the home require a greater degree of supervision for newly appointed staff that are appointed subject to a satisfactory CRB disclosure. 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 I55 s32102 redhouse v240021 290905 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 I55 s32102 redhouse v240021 290905 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) 2, 3, 5 The admission procedure is satisfactory, providing prospective service users with the opportunity to visit the home where possible. The needs of prospective service users are adequately assessed. EVIDENCE: Written contracts or terms and conditions of residence are provided to service users. Files seen provided evidence of contracts signed by service users and indicating that trial period or stay is offered. Some service users indicated that either they or a relative on their behalf had had the opportunity to visit the home prior to their accommodation. Evidence was seen in service user files of pre-admission assessments by the manager in addition to information provided by referring agencies. Assessments seen adequately addressed issues required by the Standard. The Red House I55 s32102 redhouse v240021 290905 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 & 11 Service users health and personal care needs are well attended to. Care plans are not always supported by clear information for staff to follow. EVIDENCE: Comprehensive individual care plans were available with evidence of the involvement of service users, and evidence of regular review. Care plans seen also contained evidence of the gathering of relevant ‘social’ or ‘life’ history information. The quality of individual care plans was reflected in feedback from service users, who indicated both individually and as part of a group discussion that they felt extremely well cared for at the home. The care plan for a service user identified as ‘prone to fall’ did not set out clearly what interventions were necessary to reduce the risk of further falls. Daily records for a service user whose behaviour can be challenging were seen along with their care plan. The care plan needs to set out in clearer detail for care staff how they should deal with these aspects of care. Care plans refer to the involvement of a variety of community health professionals. Service users confirmed access to, among others, the G.P, chiropodist and optician. The home consults with relatives and local services for support in the event of deterioration in the health of any service user living at the home, in order that The Red House I55 s32102 redhouse v240021 290905 stage 4.doc Version 1.40 Page 10 they may remain there. This is supported by information gathered as to the wishes of service users in the event of their death. The Red House I55 s32102 redhouse v240021 290905 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) 15 Meals in the home are good offering both choice and variety. EVIDENCE: All of the service users spoken to were complementary about the quality of the menu on offer, which offered varied and appealing options. At the time of the inspection it was apparent that service users had been provided choice as to their main meal, and choice as to where they preferred to take it. Meals seen looked appetising and were well presented. The Red House I55 s32102 redhouse v240021 290905 stage 4.doc Version 1.40 Page 12 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) 17 & 18 Arrangements for protecting service users and their legal rights are satisfactory. EVIDENCE: Service users legal rights are protected by the home. The manager indicated that were advocacy services required for service users, this would be obtained through social services. Service users are able to vote by postal ballot. A procedure for responding to allegations of abuse is in place, including ‘whistle blowing’. Staff spoken to appeared completely aware of the procedure and its function. It is evident that staff have had access to appropriate training concerning the protection of vulnerable adults. The Red House I55 s32102 redhouse v240021 290905 stage 4.doc Version 1.40 Page 13 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) 21,22,23,24,25,26 A comfortable, well-maintained and equipped accommodation is provided by the home. The interior has a noticeably homely feel, and accessible garden areas enhance the communal space available. EVIDENCE: The home provides sufficient and suitable lavatory and washing facilities. There are eight bedrooms with en-suite facilities (one shared room has an en-suite shower). There are assisted bathing facilities on each floor and a shower on the first floor. There is sufficient specialist equipment available at the home to meet service user need, though no major environmental adaptations other than suitably sited grab rails. Service user own rooms suit the individual needs and preferences of their occupants. Many service users bedrooms were clearly personalised with their own furniture and possessions, creating a very homely feel within their individual rooms. The majority of bedrooms are lockable, though not all. This work should be completed to support service user privacy. The Red House I55 s32102 redhouse v240021 290905 stage 4.doc Version 1.40 Page 14 The home provides a high standard of accommodation that is safe, comfortable and enables service users to experience the benefits of varied communal space. The home is clean pleasant and hygienic. The Red House I55 s32102 redhouse v240021 290905 stage 4.doc Version 1.40 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) 28, 29, 30 Staff have a very good understanding of service users support needs, are well trained and maintain positive relationships with service users. There are concerns about staff recruitment practices. EVIDENCE: Despite some recent staff turnover the home provides a stable, and experienced staff group. Staffing levels are comfortably above the minimum standard required. Service users indicated that there was sufficient staff available to meet their needs and felt that they were in safe hands. The home is currently achieving over 50 of care staff with NVQ 2, or above, training. Staff files reviewed showed that service users are protected by good recruitment practices. However, it was noted that in one instance that a CRB disclosure was not evident (but applied for) for s staff member who had taken up their duties at the home. Though a POVA check had been made, the supervisory arrangements for the staff member were not adequate and the allocation of a ‘named person’ to supervise the staff member at all times not made. It is evident from staff spoken to and from training records seen that staff have access to induction training and a full range of mandatory training. Staff also appeared to show interest and enthusiasm in their role. The Red House I55 s32102 redhouse v240021 290905 stage 4.doc Version 1.40 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) 33,34,35,36,37,38 The home is well managed by a competent manager who is highly regarded by service users, relatives and staff alike. The home is run in the best interests of service users. EVIDENCE: The manager’s principle strategy to ensure that the home runs in the best interests of service users is to maintain of an ongoing dialogue with service users, and this has been and is clearly effective. However, there is not yet a more formal means of self-monitoring at the home that takes account of the wider perspective of those associated with the home. This is work that needs further development, which is acknowledged by the manager. Service users financial interests are safeguarded by the home; their relatives manage the vast majority of service users financial affairs. The manager acknowledged that supervision for care staff has not been taking place at an appropriate frequency; consequently staff have not received regular supervision recently. This was explained in part by the manager as a The Red House I55 s32102 redhouse v240021 290905 stage 4.doc Version 1.40 Page 17 consequence of recent staffing turnover (referred to above) that has now been addressed. The home has appropriate policies and procedures, and satisfactory record keeping practices. The home seeks to promote the health, safety and welfare of service users, though issues identified concerning staff supervision and recruitment compromise this. The Red House I55 s32102 redhouse v240021 290905 stage 4.doc Version 1.40 Page 18 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 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 x 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x x 3 3 3 2 3 3 STAFFING Standard No Score 27 x 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 3 x x 2 3 3 2 3 2 The Red House I55 s32102 redhouse v240021 290905 stage 4.doc Version 1.40 Page 19 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(4)(c) Requirement Timescale for action Immediate and Ongoing 31st December 2005 2. 24 3. 29 4. 33 5. 36 The registered person must ensure that care plans and risk assessments provide clear information for staff to follow. 12(40(a) The registered person must & ensure that the home provides 23(1)(a) suitable locks on bedroom doors to support the privacy of service users and the security of their belongings. 13(4)(c) & The registered must ensure 18(2) adequate supervisory arrangements for any staff appointed subject to satisfactory CRB disclosure. 24(1) The registered person must establish and maintain a system for reviewing and improving the quality of care provided at the home. 18(2) The registered person must ensure that staff at the home are appropriately supervised. Immediate and Ongoing 28th February 2006 Immediate and Ongoing RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. The Red House I55 s32102 redhouse v240021 290905 stage 4.doc Version 1.40 Page 20 No. 1. Refer to Standard Good Practice Recommendations There are no recommendations in this report. The Red House I55 s32102 redhouse v240021 290905 stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF 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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