Inspection on 09/03/06 for The Red House

This inspection was carried out on 9th 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Red House 26/08/06

The Red House 23/09/05

The Red House 25/01/05

The Red House 17/05/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 The Red House 65 Ruspidge Road Cinderford Glos GL14 3AW Lead Inspector Ms Tanya Harding Unannounced Inspection 9th March 2006 10.45 The Red House DS0000043069.V286176.R01.S.doc Version 5.1 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 DS0000043069.V286176.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 Adults 18-65. 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 DS0000043069.V286176.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Red House Address 65 Ruspidge Road Cinderford Glos GL14 3AW 01594 822100 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) red.house@craegmoor.co.uk Park Care Homes (No 2) Ltd Miss Andrea Creed Care Home 8 Category(ies) of Learning disability (8) registration, with number of places The Red House DS0000043069.V286176.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd September 2005 Brief Description of the Service: The Red House is a detached residential care home situated 1.5 miles from the centre of the town of Cinderford. There is a shop and a pub close by. The home provides accommodation and care for up to eight adults with learning disabilities who may also have challenging behaviour. The accommodation is spread over three floors and the home is surrounded by attractive terraced gardens. The home has its own registered manager and is owned and run by Craegmoor Healthcare. The Red House DS0000043069.V286176.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on Thursday morning and lasted approximately three hours. The acting manager supported the inspection. Several of the service users were greeted and observed in the home. A number of documents were examined including those relating to service users’ care, incidents and accidents. Following the inspection a meeting took place with the acting manager and the deputy to discuss procedures around reporting of events which may adversely affect the wellbeing of the service users. This report should be read in conjunction with the report from the previous inspection for a more comprehensive picture of the home. 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 contacting your local CSCI office. The Red House DS0000043069.V286176.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Red House DS0000043069.V286176.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not assessed. EVIDENCE: At the time of the visit there was one vacancy in the home. The acting manager advised that some referrals have been considered but not taken up at present. The Red House DS0000043069.V286176.R01.S.doc Version 5.1 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 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 Measures for managing service users’ personal finances are effective in protecting people from possible financial mismanagement. EVIDENCE: The home has well developed systems for recording and managing personal moneys received by the service users. All expenditure is recorded and these records are checked against moneys kept for each person twice a day and two staff are required to sign after each check. Secure storage is provided and access to service users moneys is restricted to senior staff only. The service users are encouraged to sign for the money when the take it out. Two service users have expressed a wish to have greater control over their money. The home has provided the necessary guidance and support to enable for this to happen. The acting manager advised of plans to develop more person centred care guidance for each service user. The Red House DS0000043069.V286176.R01.S.doc Version 5.1 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 The home supports service users to maintain links with their families and friends. EVIDENCE: There are arrangements in place for individual residents to maintain contact with their families and friends. The acting manager advised that the service users are supported to maintain contact and that visits to the home by relatives and friends are encouraged. For one person links have been re-established with their family after a long time of no contact. It is felt that this has been an important aspect of the person’s life which has not been addressed in their previous placement. The Red House DS0000043069.V286176.R01.S.doc Version 5.1 Page 10 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Service users receive personal care support in line with their preferences. EVIDENCE: Care plans around personal care were examined for two service users. The basic details of how the support would be delivered were included. The acting manager also felt that most of the service users would tell the staff supporting them of the ways they would prefer to receive this help. It is anticipated that a more person centred format will provide even greater detail of what people want. There were also care plans about providing emotional support to the service users and these focused on increasing the feelings if self-worth and confidence. The Red House DS0000043069.V286176.R01.S.doc Version 5.1 Page 11 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Appropriate measures are in place to safeguard the welfare of residents and to provide them and their representatives with the opportunity to raise concerns. EVIDENCE: The majority of the service users in the home are able to self-advocate. There are procedures in place for responding to complaints and for supporting the service users to voice their concerns and dissatisfaction. Comments receive from relatives following the last inspection were on the whole very positive and provided evidence that the home takes any concerns seriously. A discussion took place with the acting manager and the deputy following the inspection to clarify when the Commission needs to be notified of events under Regulation 37. The home has been providing notifications of most incidents as necessary, but would need to include any occasions when physical intervention may be used; there is a conflict in terms of physical aggression between the service users and any occasions when the service users may abscond. The acting manager advised that the use of restraint has reduced considerably in the home and this is mainly because the staff are competent in following agreed management strategies and do so consistently. There is close monitoring of all incidents with a monthly overview compiled for specific service users, which provides an analysis of each incident to determine possible triggers. Staff are provided with opportunities to debrief formally following a serious incident and this is good practice. The Red House DS0000043069.V286176.R01.S.doc Version 5.1 Page 12 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not assessed. EVIDENCE: The Organisation provided confirmation that plans for redevelopment of the dining and kitchen area are being formalised and will be forwarded to the Commission in due course. The main hall was being decorated on the day of the visit. The lounge area has also been redecorated and provided a very pleasant environment in which the service users were seen to be relaxing. Paper towel dispensers and soap dispensers have been fitted in the laundry room and in the kitchen as required in the last report. The home has received a visit from the Environmental Health officer. There were a number of recommendations issued to improve the safety practices around food preparation and storage in the home and the acting manager conformed that these are being actioned. The Red House DS0000043069.V286176.R01.S.doc Version 5.1 Page 13 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Good focus on staff training and development should ensure that the service users are supported by a motivated and skilled team. EVIDENCE: Observations during the visit provide evidence that staff take a genuine interest in supporting the service users and interact with people in a respectful and calm manner. There was evidence of regular staff meetings taking place with good attendance. Some of the topics included discussions about evaluation of care plans, looking at activity provision and planning for the service users’ holidays. Staff files were examined for three new staff. There was evidence that the required pre-employment checks have been obtained including CRB disclosures and references. Staff files contained evidence of induction, supervision and appraisals. At the time of the inspection recruitment was proposed for night staff, a support worker and a bank worker. The acting manager is aiming to provide two waking carers at night to overcome difficulties presented by the layout of the home. In addition to mandatory training the home is always looking for staff to develop skills and understanding of the specialist needs and diagnosis of the The Red House DS0000043069.V286176.R01.S.doc Version 5.1 Page 14 service users. This is done with help of the professionals from the Community Learning Disabilities Team, research and information sharing and access to the external training. There are plans for the deputy manager to cascade awareness training in Autism to the rest of the staff team, once she has completed the facilitator’s course. The team receive regular input from the behaviour nurse therapist. The therapist also provides awareness training about challenging behaviours for new staff as part of their induction. There has been no formal training in epilepsy, but this is something the home may be considering and would seek advice from the Community Nurse. Training in responding to aggression is changing in the home and staff will now be asked to complete CPI (crisis prevention) training which covers deescalation as well as use of physical interventions. The acting manager advised that the floor restraint is not part of this training and will no longer be taught to staff. The Red House DS0000043069.V286176.R01.S.doc Version 5.1 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42 Residents benefit from a well run home. Service users’ views are listened to and used to assess people’s satisfaction of the support they receive. There are good systems for monitoring of health and safety in the home for the benefit of the service users. EVIDENCE: The registered manager was on long term leave at the time of the visit and it is anticipated that she would return to the home in June 2006. The acting manager’s cover is being provided by the deputy manager. The acting manager presented as competent and knowledgeable about the service and its requirements. The home has developed a business plan to which staff are asked to contribute. There are systems in place for checking all aspects of care delivery in the home daily ad through staff meetings. The acting manager advised that a new The Red House DS0000043069.V286176.R01.S.doc Version 5.1 Page 16 hand-over sheet is being introduced to ensure all the necessary information is passed effectively between staff on different shifts and provides a written record of evidence. Communication books are also used to promote communication between staff. The home seeks feedback from the service users and their families on regular basis. Relative’s questionnaires have been sent out two weeks prior to the inspection and this exercise will be repeated every six months. Feedback from the last round of questionnaires contained some very positive comments. On one form a relative made a request, and the manager provided evidence that this has been followed up and responded to as necessary. Questionnaires completed by the service users provided evidence that people think of The Red House as their home and take pride and responsibility in it. There are regular residents’ meetings and minutes of these were seen. Fire safety records are kept and check on fire alarms and emergency lighting is carried out as necessary. The home has a health and safety committee which meets every month to discuss aspects of safety and risk assessments which are relevant for the home. One of the service users has been involved in hazard analysis and it is felt that regular contributions from the service users will be sought about the safety of the home environment in the future. Accident records are kept as necessary. The Red House DS0000043069.V286176.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X X X X X 3 X X 3 X The Red House DS0000043069.V286176.R01.S.doc Version 5.1 Page 18 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 YA24 Regulation 23 Requirement Provide a planned maintenance schedule for the necessary improvements to the dining and kitchen areas. Timescale for action 31/05/06 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 Standard Good Practice Recommendations The Red House DS0000043069.V286176.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 DS0000043069.V286176.R01.S.doc Version 5.1 Page 20 - 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. 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