Inspection on 07/03/06 for The Red House

This inspection was carried out on 7th March 2006.

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 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 27/06/05

The Red House 28/02/05

The Red House 05/11/04

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

CARE HOMES FOR OLDER PEOPLE The Red House 8 The Village Kingswinford West Midlands DY6 8AY Lead Inspector Mr Jon Potts Announced Inspection 7th March 2006 09:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Red House DS0000025041.V285992.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Red House DS0000025041.V285992.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Red House Address 8 The Village Kingswinford West Midlands DY6 8AY Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01384 291757 01384 291757 davidjodonnell@hotmail.com Mr David John O`Donnell Mrs Shirley Nita O`Donnell David O`Donnell Care Home 8 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (1), Old age, of places not falling within any other category (7) The Red House DS0000025041.V285992.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27/06/05 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 resident’s accommodation is provided on the ground and first floors the later accessed 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 presentation. The home has a small staff group, members of which have worked at the home for a number of years. The main aim of the home is to offer family style living and personal care in a small homely unit for older people of either gender. The home offers mostly. long stay accommodation, but has on occasions offered some short-term care. Emergency care may 7be provided dependent on individual circumstances. The Red House DS0000025041.V285992.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the course of this announced inspection the inspector drew evidence from a number of sources that included case tracking the care provided to three residents this involving examination of their care records. Other records were examined included policies/procedures, the homes quality assurance system and some training records. The provider also submitted information in the form of a pre inspection questionnaire. There was discussion with four residents with additional comments received from two relatives through CSCI comment cards. The residents 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: Some limited and specific areas in respect of the records kept by the home need to be more up to date, with in house reviews of care plans needing to be more frequent. All Care plans also need to be signed by residents or their representatives. An additional member of staff needs to undertake NVQ level 2 training. The lounge carpet would benefit from replacement, this planned by the providers. The Red House DS0000025041.V285992.R01.S.doc Version 5.1 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 DS0000025041.V285992.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Red House DS0000025041.V285992.R01.S.doc Version 5.1 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): 1,3,5 Prospective residents have the information needed to make an informed choice as to the suitability of the Red house as their home, this following assessment by the home. The homes ability to meet the prospective resident’s assessed needs are confirmed prior to their moving into the home, and there is opportunity to visit the Red house if the resident wishes. EVIDENCE: The home has a statement of purpose and service user guide that has been seen by the inspector on previous visits and there was evidence of to show that residents recently admitted had been supplied with copies of the same. There was clear evidence of the home obtaining assessment information in respect of new admissions to the home and also confirming the homes ability to meet assessed needs. Discussion with one recently admitted resident evidenced that whilst they had chosen not to visit the home prior to admission their relative had done so on their behalf, this in accordance with their expressed wishes. The Red House DS0000025041.V285992.R01.S.doc Version 5.1 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): 7,8,10 The resident’s health, personal and social care needs are set out in an individual plan of care and health care needs are provided for in accordance with individual choices. Resident’s stated that their privacy and dignity is respected and upheld by staff. EVIDENCE: All the case files examined carried copies of a care plans these containing details of the needs of the residents whose care was tracked, the layout of these documents improved upon since the last inspection; this so that there was a greater range of information. Case tracking of the information within the plans evidenced that the detail within them was accurate. The plans were seen to be reviewed six monthly at present (in some depth), these in-house reviews needing to be carried out monthly as a minimum. One out of three 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. Other documentation within this one residents case file was however signed by the resident. Risk assessments were carried in case files in respect of appropriate areas of risk that included nutrition, tissue viability and moving The Red House DS0000025041.V285992.R01.S.doc Version 5.1 Page 10 and handling. There was clear evidence of the residents having appropriate access to community health care services where this was their choice. Residents spoken to confirmed that the way their care was provided upheld and catered for their privacy and dignity. The layout of the building also allowed access to privacy where this was required. The Red House DS0000025041.V285992.R01.S.doc Version 5.1 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): 14, 15 Residents are helped to exercise choice and control over their lives. Residents receive a wholesome, balanced diet in accordance with their choices. EVIDENCE: Discussion with residents evidenced that they felt they were given choices in respect of their day-to-day life. There was documented statements in case files as to choices made in respect of items of furniture they wished to have in their rooms, times they wished to rise and retire (these found to be accurate) and involvement in respect of their financial affairs. There was evidence from signed documentation of residents having access to documentation in their case files, this also confirmed to be the case by some of the residents. One resident’s choices in respect of meal presentation was seen to be respected by the home, this based on comments by the resident, documentation and sight of the meal served to them. Comment was made by residents as to the quality of the food, which was said to be “Lovely”. Comment on the bread was that it was “ not cheap bread and brown if wished”. Some of the gateau’s given to residents were said to be “out of this world”. The homes planned menu showed that a balanced and nutritional diet was available. The flavour of the tea (beverage) was also noted to be excellent (this sourced from a company in Somerset). Residents were The Red House DS0000025041.V285992.R01.S.doc Version 5.1 Page 12 seen to have a choice of where to eat their meals, and the dining room was seen to provide a congenial setting, although residents were seen to have the option of eating alone in their room if wished. The Red House DS0000025041.V285992.R01.S.doc Version 5.1 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): These standards were not fully assessed at this inspection. EVIDENCE: Whilst these standards were not fully assessed the staff at the home have received training in adult protection since the last inspection, this a distance learning course that was externally marked. The Red House DS0000025041.V285992.R01.S.doc Version 5.1 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): 19,23 The Red House presents as a comfortable and homely environment that is well maintained. Residents considered their bedrooms to be suitable for their needs. 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. The ground floor hallway and one bedroom have been recarpted since the time of the last inspection and there are plans to recarpet the lounge where the carpet is worn in part. Redecoration in the hallway was seen to be on going. There was seen to be a redecorative programme in place. Those residents spoken to stated that their bedrooms suited their needs and that the furniture provided was in accordance with their wishes. A number of these choices were recorded and signed by the resident in case files. The Red House DS0000025041.V285992.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28 Sufficient and experienced staff meet the needs of the residents. Staff competence and knowledge would be enhanced through further vocational training although residents are judged to be in ‘safe hands’. 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, with comment as to the attentiveness of staff and quick responses when assistance is required. The two responses from relatives via comment cards also indicated satisfaction with staffing levels. As the home is a small unit the manager/provider and partner are very involved in the delivery of care. 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 DS0000025041.V285992.R01.S.doc Version 5.1 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 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): 33,35 Work done towards evidencing that the home is providing a service in the best interests of the residents, this since the last inspection, is a positive step. Resident’s financial interests are safeguarded. EVIDENCE: The manager/provider has introduced a quality assurance tool since the last inspection, this based on a comprehensive audit of numerous standards based around the national minimum standards and other guidance/legislation. The manager was seen to have commenced this audit and produced an ‘at a glance’ annual development plan based on the findings of the audit to date. The manager was advised to date when he had audited standards as opposed to ticking them off this to make it easier to identify when the standard was audited, and also to consider auditing the standards over a set period such as The Red House DS0000025041.V285992.R01.S.doc Version 5.1 Page 17 over twelve months to make the task more manageable. There was evidence of consultation with relatives and residents through questionnaires, although the manager was advised to look at gaining the views of other stakeholders such as social workers, G.P.s etc as possible so that this evidence could be used within the audit of the above-mentioned standards. It is however recognised that the work done towards improving the homes quality monitoring system and evidencing that the home is providing a service in the best interests of the residents has notably improved since the last inspection. The manager is involved in the financial affairs of one resident although discussion with this resident evidenced that this was with their full agreement. The last review by social services indicated that they were fully aware of this involvement and had no objections. There was seen to be clear and appropriate records of any money handled. There were appropriate procedures in respect of safeguarding residents financial interests in the homes policies and procedures file and case files were seen to contain copies of inventories of resident’s valuables. The Red House DS0000025041.V285992.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X 3 X X X STAFFING Standard No Score 27 3 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X x The Red House DS0000025041.V285992.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement The care plans must be reviewed monthly and reflect any changes to the care provided as they happen. All care plans must be signed by the resident and/or their representative to evidence their awareness of the plan. This is a repeated requirement that is partly met. There must be at least 50 of the staff team qualified to NVQ level 2 in care or above. This is a repeated requirement that was to have been met by the 31.12.05. Timescale for action 30/04/06 2. OP28 18 30/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000025041.V285992.R01.S.doc Version 5.1 Page 20 The Red House 1. 2. 3. Standard OP19 OP31 OP33 To replace the lounge carpet as is planned by the registered providers. For the registered manager to complete his NVQ level 4 in care qualification. To date on the quality assurance record when an audit of a set standard is carried out and to consider consulting with all stakeholders on an annually basis (this to include such as district nurses, G.P s, opticians etc). The Red House DS0000025041.V285992.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA National Enquiry Line: 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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