Inspection on 23/05/07 for The Red House Nursing Home

This inspection was carried out on 23rd May 2007.

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 Nursing Home 12/10/06

The Red House Nursing Home 04/07/05

The Red House Nursing Home 25/05/05

The Red House Nursing Home 22/10/04

The Red House Nursing Home 10/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings 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 Nursing Home London Road Canterbury Kent CT2 8NB Lead Inspector Mrs Susan Hall Key Unannounced Inspection 09:30 23 & 24th May 2007 rd 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 Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 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 Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Red House Nursing Home Address London Road Canterbury Kent CT2 8NB 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) 01227 464171 01227 788084 The Red House Nursing Home Limited Mrs Susanne Elizabeth Williams Care Home 31 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (31) of places The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th October 2006 Brief Description of the Service: The Red House Nursing Home is a large, detached property which used to be a Victorian vicarage in previous days. It is set in it’s own grounds, with large attractive gardens at the front of the property, and overlooking one of the main roads into Canterbury. It is a family owned business, and the Provider and her son and daughter are actively involved in overseeing the running of the home. The premises have two lounge areas and a dining room, and most bedrooms are for single use. A passenger lift enables easy access to the first floor. Many bedrooms have en-suite facilities. The home is situated near to the city centre with all it’s accompanying resources. There are good transport links, and on site car parking for several vehicles. The home provides nursing care for up to 31 older people, and can also take up to 8 older service users who have dementia (and nursing needs). The Manager checks the suitability of the placements prior to admission, to ensure that service users will be compatible. The fees range from £595 - £645 per week, depending on the room available and the dependency needs of the service user. This information was provided by the manager in May 2007. The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a Key Inspection, which included assessing all of the Key Standards. The Inspector was also able to assess most other standards during this inspection. The process included amalgamating all information received by the CSCI office since the last inspection (e.g. formal notifications, phone calls, and letters); reading survey forms produced by the home; reading CSCI survey forms sent out to health professionals; and visiting the home over a two day period. The visit was unannounced, and the Inspector was assisted on the first day by the nursing staff, as the manager was on a day’s leave. The Inspector decided to complete the visit on a second morning, in order to meet with the manager, and obtain clarity on some specific details. The visit included viewing the home – which included viewing all communal areas, most bedrooms, and other facilities; reading documentation such as care plans and medication charts; and talking with as many people as possible. She had meaningful conversations with seven residents, and spoke briefly with several others; and with three relatives, and ten staff (apart from the manager). Residents were sitting in different areas according to choice – their own rooms, the lounges, or the garden. They were able to talk in a relaxed manner with the Inspector, and it was clear that they felt confident in sharing their views and opinions. They said that they knew that the manager and staff would listen to any concerns and take action on these. Several made comments such as “the care is top class here, I am very well cared for”; “ I am quite content, very well cared for, and very well fed”; and “the staff are lovely and look after me very well”. The Inspector noted that the management had been working hard to meet previous requirements and recommendations, and this has resulted in higher overall standards of care. What the service does well: The service provides a pleasant and homely environment, with a friendly and caring atmosphere. Residents’ individual wishes and preferences are taken into account, and the service centres on trying to meet individual choices as much as possible. The nursing staff work with the manager to ensure that health needs are met, and that good health care is promoted throughout the home. The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 6 Activities are provided with a sensitivity as to what residents really want, and include one to one time as well as group activities. Visitors are really welcomed into the home and included in the life of the home wherever possible. 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 summary of this inspection report can be made available in other formats on request. The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 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 Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 (Standard 6 does not apply to this service). People who use the service experience good quality outcomes in this area. The home provides detailed information to enable prospective residents to make an informed decision. Comprehensive pre-admission assessments are carried out to check the suitability of the placement. EVIDENCE: There have been no changes to the Statement of Purpose, or Service Users’ Guide. These documents were viewed at the last inspection, and were seen to contain all the required information. They are well set out and easy to read. There is an additional brochure which includes photographs of the home. All residents are supplied with a contract, and terms and conditions of residency. Pre-admission assessments are carried out for all prospective residents, and the Inspector viewed three of these assessments. They are usually carried out The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 9 by the manager, who takes comprehensive details in regards to health and personal care needs. Details include a previous medical history; a history of any falls, and mobility needs; current diagnosis and personal health needs; continence care; skin integrity; nutritional needs; social preferences, mental state, and medication. The manager checks if any special equipment is needed, and assesses if the room available will be suitable in regards to this. Residents and relatives are encouraged to visit the home and to look round. They are able to meet staff and other residents, and view available rooms. Residents are admitted for a four week trial period, and after this time, a review is held to check that the placement is suitable. The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7-11 People who use the service experience good quality outcomes in this area. Care plans are kept up to date and give a comprehensive view of changing health needs. Residents are confident that staff will meet their care needs with respect, and attention to detail. EVIDENCE: The inspector viewed three care plans and noted that these are well completed and have sufficient details. They are set out in a format which is easy to follow. Care plans are initially based on pre-admission and admission assessments, and are then developed as the need arises. There is a good system in place to ensure that these are reviewed every month, and are kept up to date. Care plans include details such as how to manage mobility needs, personal hygiene, pressure relief, continence care, social preferences, mental health needs, medication and pain relief. Care staff are allocated to different areas of the home each morning, and report back any changes to the nursing staff. Nurses then complete a daily record, which is further updated later in the day, and at night. Care plans are stored confidentially, but with easy access for The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 11 nurses and care staff. Nurses ensure care staff have clear handovers for new residents – for example identifying which hoist and sling to use for a resident with mobility needs, or informing them of a specific diet. Daily handovers ensure continuity of care. The nurses keep a diary to remind them which dressings are due, and which care plans are due for review. Wound care is well managed, and includes photographs of wounds, graphs and body mapping to keep clear records of the progress of wound healing. Good details of care include giving pain relief prior to dressing changes. Health professionals are called in as needed. One resident had recently had an optician’s visit, and was eagerly awaiting new glasses. GPs are contacted as needed, and referrals are requested for health needs such as physiotherapy, occupational therapy, or specialist nurses. Medication is stored in a small clinical room and is well organised. Storage cupboards and the medication trolley were inspected, and were found to be in good order, and with evidence of stock rotation. There was no overstocking. External creams are stored separately. Specialist items such as insulin and eye drops are stored correctly, and are dated on opening. Room and fridge temperatures are monitored and are satisfactory. Medication administration records (MAR charts) were viewed, and were seen to be good, clear records. Each MAR chart is accompanied by an additional sheet containing a photograph of the resident. Allergies were not clearly identified on MAR charts, and the manager stated she would consider adding these to the photograph sheets. Residents were seen to be well groomed, clean and tidy, and sitting happily in their rooms, the lounges, or outside, according to choice. Staff spoke to them kindly, and showed genuine care. Residents said that they “can easily share any concerns with matron” (the manager). Resident were easily able to converse with the Inspector, and there was no sense of them feeling they had to be careful what to say. Some were very forthright, and expressed themselves very clearly. There was no doubt that residents’ feel they are well cared for, and that they are confident that any matters they raise will be quickly attended to. Residents are spoken to by their title of choice, and this is strictly adhered to. They are enabled to get up/go to bed as they wish, and to join in with activities when they want to. The manager ensures that compassionate care is given to residents who are dying, and keeps relatives informed at all times of any changes. Relatives can come and stay for as long as they like, and there are facilities to stay overnight if they wish to do so. Staff will sit quietly with a resident if relatives are not available. The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 People who use the service experience good quality outcomes in this area. The home has an ethos of promoting residents’ choice, and routines are flexible to enable the service to meet individual wishes. Food is of good quality and is well prepared. EVIDENCE: The home employs an activities organiser for ten hours per week, and she meets each new resident (and relatives), and gets to know their preferences. Many residents said they like to stay in their own rooms most of the time. There were a few in the lounge who were clearly happy to be there together. One was in the quiet lounge reading a book, and four sat outside on the patio with the activities organiser, and enjoyed chatting together for about an hour. The activities organiser spends time on group activities (flower arranging, crafts, reminiscing etc.) and also on one to one time. Residents may just want to chat; or want a library book changed. Other residents were seen reading newspapers, doing crosswords, watching TV, reading books, or chatting together. The activities organiser arranges special events on a regular basis, and was in the process of advertising a forthcoming talk on Kenya. The owner comes from The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 13 Kenya, and residents wanted to know a little about this country. The speaker will bring large pictures/photos etc, to enhance the occasion. Other forthcoming entertainment included hand bell ringers (which they really like), and an accordion player. The organiser has gradually changed the activities programme over the past year to accommodate changing preferences. She was also in the process of arranging three outings to take place during Summer months – probably to seaside towns. Residents said they like the things there are to do, and there is enough choice. The activities organiser has developed a large folder of photographs of different outings and activities in the home. As well as being a record of the different things they do, this is also very useful to show prospective residents and relatives, so that they get a flavour of life in the home. The organiser also keeps a detailed record for each occasion when residents take part in activities, or if she has one to one time with them. This is also very helpful for relatives and care managers to see the different things residents are able to take part in, and to record the activities they most enjoy as individuals. Residents are provided with the opportunity to attend religious services of their choice. Visitors are made to feel welcome, and are always offered tea/coffee. Some residents will join in more with activities if their relatives are present. The inspector visited the kitchen, and this was clean and well organised. Residents said that the food is very good, although one said it could be “more imaginative”. However, the cook does not currently carry out most of the food ordering, and works with the ingredients provided. The cook may be given more responsibility for this overall aspect of the food management in the future. Residents said that food is wholesome and is well prepared. There is fresh fruit available every teatime, or as asked. Residents have a good liaison with the cooks, as the cooks speak to residents each afternoon and ask for their choice for teatime, and for lunch the next day. The catering staff go out of their way to get extra food items if requested. Care staff (nights) prepare breakfasts and will provide cooked breakfasts if wanted. Snacks are available at any time. Cooked items such as desserts, quiches, pies, cakes etc. are all home made. Records are kept to show each resident’s choice of food each day, and how much they have eaten. This is good practice to check the levels of nutrition. Weights are completed on a monthly basis. Residents spoke highly of the food; and lunch was seen to be well cooked, and nicely presented. The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 People who use the service experience good quality outcomes in this area. The home has a robust complaints procedure in place, and the manager ensures that any complaints are thoroughly followed up, and dealt with appropriately. Residents are protected from abuse. EVIDENCE: Complaints are recorded in a hardback notebook by the member of staff who receives the complaint. These are then followed up by the manager, ensuring that the complaint is properly managed and resolved. There had been two complaints since the last inspection, and the notebook had been completed to show the action taken. Each outcome is again reviewed within a given timescale (e.g. 1 week, 1 month) to ensure that the person who complained is still satisfied with the outcome. Any complaints of a more serious nature are recorded separately, with all details of any ongoing investigation. The records showed good liaison with relatives/advocates or health professionals as appropriate. The home had one referral to the Social Services Adult Protection department since the last inspection. This was in regards to a resident who suffered an injury after getting out of bed unaided. The Adult Protection team concluded that the home took immediate and correct action in regards to this resident’s welfare. Very good records were maintained of the resulting action. The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 15 Staff are given basic training in regards to prevention of adult abuse during their induction. A programme has been drawn up to provide ongoing and more in-depth training in this subject for all staff. There is a new policy in place for the promotion of adult protection. The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19-26 People who use the service experience good quality outcomes in this area. There has been an ongoing programme of redecoration, and this has improved many areas of the home. The grounds are excellently maintained. EVIDENCE: The inspector viewed all communal areas of the home, and most of the bedrooms. There was evidence of lots of redecoration, new carpets, and some new furniture. The premises were clean in all areas, except for one bedroom carpet which was in the process of being cleaned. There are two cleaners on duty each day, including weekends, and they check every room, every day. Communal areas are pleasant to sit in, and are suitably decorated and furnished. Most bedrooms are for single use and are personalised according to choice. These are redecorated on a rolling programme. New residents may be offered a shared room for short periods of time if a single room is not vacant, and then transferred as a vacancy occurs. The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 17 The home has suitable bathing facilities, and includes different types of baths and hoists, and a separate shower unit. Bath temperatures are checked before each use. All rooms are fitted with call bells, and these were seen to be left so as to be accessible to residents. At the last inspection, there were areas of the home which were quite cluttered. This has all been dealt with, and improves the home’s appearance, as well as reducing health and safety hazards. Wheelchairs are now tidily stored in a storage room. One bedroom had a brick to hold open the door when the resident requests this. The manager said that this had previously been agreed with a fire officer, but is now only an interim measure while fixtures are being put in place for every door to close when the fire alarm sounds. The management need to ensure they can evidence that fire procedures are in accordance relevant legislation. Radiator covers are evident throughout the home, and all hot pipes have been covered. There is a sluice on each floor. Both are kept very clean, and one includes a sluice disinfector. The home is suitably equipped with grab rails in the corridors and toilet areas, pressure-relieving equipment, hoisting facilities, and a passenger lift. All bedrooms now have nursing beds. There is an ongoing programme for fitting locks to all bedroom doors. The laundry room is very small, and poorly sited in the centre of the ground floor. It contains two commercial washing machines and one dryer. Dirty linen is kept in wheelie bins just out in the corridor, and this is a good practical idea for the promotion of infection control. There is a hand washing area in the laundry room, and another in the sluice room which is immediately adjacent. Protective clothing is provided. Due to the size of the room, and the lack of ventilation, there is a fan provided for the laundry assistant. This is needed on most days to keep the temperature to a reasonable level. The main laundry assistant works full time in the week, and there is another assistant to cover at weekends. The Inspector noted that there were a few chemicals stored on a shelf, and these should be locked up when not in use. This is addressed in standard 38. The grounds are excellently maintained, and include sweeping lawns at the front leading down to the main road. This provides a very pleasant outlook. There is a patio area which is easily accessible, and looks out over the main gardens. The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27-30 People who use the service experience good quality outcomes in this area. Staffing levels have been revised, and satisfactory levels of staffing are maintained. The service has improved standards and availability for mandatory staff training. EVIDENCE: Staffing rotas show there are 2 nurses in the mornings, and 1 at other times. This has changed since the last inspection visit, and is clearly an improvement in continuity and nursing care to have 2 nurses on duty each morning. Sometimes the manager is the second nurse, but her hours are usually supernumerary. There are 4 care staff in the mornings, 3 in the afternoons/evenings, and 2 at night. Staff said that this ratio was currently satisfactory. The home had four vacant beds at the time of the inspection, and the manager stated that staffing needs would be reassessed with each additional resident admitted. Having 3 carers in the afternoons is an improvement on the previous level of 2, as they are more available to residents, and can now get all the extra jobs done – such as cleaning wheelchairs, tidying rooms etc. There is a job allocation for these items every afternoon. Additional care staff are brought in for escort duty if a resident has a hospital appointment or other health need outside the home. The home is registered The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 19 with two agencies, so that any shortfall (e.g. sickness) can be made up. The agencies work with the manager to try and provide continuity with staff. Care staff have allocations for where they are working each day, as well as their jobs allocations for care staff each afternoon. There is a senior carer for most shifts. There are good systems in place for carers to report to the nursing staff about any changes in residents’ conditions. There is a good team of ancillary staff, so that care staff can concentrate on caring. This includes two cleaners every day, a full time laundry assistant each day, a cook and kitchen assistant, and maintenance staff. The housekeeper oversees all the cleaning and general house management. The home has several care staff who have completed NVQ 2 or 3, and others who are working towards this. The percentage is still below 50 , and so the home needs to keep working at this situation. Recruitment practices were checked with the manager. Proof of identity, a current photograph, two written references, POVA first check and Criminal Record Bureau check are all obtained prior to appointment. Copies are taken of any relevant up to date training. The application form is well laid out, except that it still requests an employment record for the last 20 years. While this is a long time, it does not comply with the requirements to ask applicants to provide a full employment history. The manager said this would be amended. There is a recommendation to ensure this is done. The manager has implemented a training matrix to show training which is booked during the year. This includes verification of staff training in mandatory subjects, including health and safety, infection control and moving and handling. Other training is also made available, such as a Vocational Related Qualification in dementia care. This is a 26 week distance learning course which some staff are carrying out, and will give them a greater level of awareness for residents who are becoming more mentally frail and confused. A separate matrix is still needed to show the training which staff have completed, so that authorised people can see that each staff member has carried out the required training. Nursing staff have sufficient opportunity to keep their own competencies and skills updated. The Inspector viewed the outline of the induction process. This takes place over the first 3 days, and includes all the necessary training and information. The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31-33, and 35-38 People who use the service experience good quality outcomes in this area. The manager provides effective and competent leadership in the home, ensuring that it runs smoothly and efficiently. EVIDENCE: The manager has many years of experience in caring for older people, and is a level 1 nurse. She has shown herself to be competent in all areas of management, and provides a good example for other staff to follow. Staff, residents and relatives expressed their confidence in her leadership. She maintains good working relationships with staff, and keeps herself informed of all changes in regards to residents’ health and welfare. Staff work together well as a team to provide good levels of care. Residents are clearly The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 21 confident that their needs will be met, and also that their wishes and preferences are listened to and acted on. Quality assurance processes include the manager having an open door policy, and making herself available to residents and relatives. She tries to visit each resident nearly every day, so that she maintains a presence in the home, and is familiar with all residents’ needs and feelings. The home produces a questionnaire survey at least once per year, and this had just been sent out to residents and visitors. The survey includes questions about all aspects of life in the home, such as the cleanliness of the home, management of laundry, food, activities, outings etc. The Inspector viewed 8 responses, and these showed clearly that residents and relatives are mostly very satisfied with how the home is running. One or two made some constructive comments about how things could be further improved. These surveys can be completed anonymously if preferred. The Inspector was able to chat briefly with 3 different relatives. One of these said they would not want to put their relative in any other home, and another said that “the home is wonderful, we are so pleased with it”. The manager evidenced where the service had made improvements as a result of a previous survey – for example, it was identified that more chairs were needed for visitors, so some were purchased. This shows that people’s viewpoints are listened to and acted on. Staff meetings are held on a regular basis, and staff said that they are able to share their views and ideas on these occasions. The home encourages residents or relatives/advocates to manage personal finances. Occasionally the home will help with management of personal “pocket monies” where relatives are not available. Advocates/solicitors are arranged for assistance with other financial dealings if needed. Pocket monies are stored individually in a safe place, and records are retained of all transactions. Staff have ongoing informal supervision on a day to day basis, and know that the manager is accessible to them for any concerns. However, a process of formal one to one supervision has not yet been implemented, and there is a recommendation to put this in place. The manager has drawn up a format for yearly staff appraisals, and these are also being implemented. Records in the home were seen to be well maintained and up to date. Storage of residents and staff records is satisfactory, and maintains confidentiality. Policies and procedures are reviewed yearly, and cover all aspects of life in the home. The manager promotes safe working practices, including fire prevention. The fire risk assessment is checked yearly by an approved fire officer. All staff have The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 22 yearly training in fire prevention, and this was well evidenced for the previous year. A few chemicals were seen stored on a shelf in the laundry, and the Inspector pointed out that all chemicals should be kept locked up when not in use. The manager stated that this would be attended to immediately, and there is a recommendation to check that satisfactory arrangements have been made. Other records were viewed for electricity and gas maintenance, hoists and lift servicing, and the home’s insurance certificate. These were all up to date. The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 23 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 X 3 3 3 3 The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard OP28 OP29 OP30 OP36 OP38 Good Practice Recommendations To keep taking measures to increase the ratio of care staff with NVQ level 2 training. To ensure that application forms are altered to require a full employment history. To complete the staff training matrix which demonstrates that all staff have been given all mandatory training. To implement formal one to one supervision for all staff. To ensure that all chemicals are stored in a locked place when not in use. The Red House Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Nursing Home DS0000026112.V337425.R01.S.doc Version 5.2 Page 26 - 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. 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