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Inspection on 23/09/05 for The Red House Nursing Home

Also see our care home review for The Red House Nursing Home for more information

This inspection was carried out on 23rd 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is bright and airy and decorated to a high standard. Residents were well groomed and appeared well cared for. Those spoken to were complimentary concerning the care and attention received.

What has improved since the last inspection?

A continuous programme of maintenance and redecoration has made this a very pleasant place in which to live.

What the care home could do better:

The integration of residents with a diagnosis of dementia has an adverse effect on the lives of the other residents. Improved supervision of this sometimes disruptive group would be beneficial.

CARE HOMES FOR OLDER PEOPLE Red House Nursing Home, The Highcross Syresham Brackley Northants NN13 5TJ Lead Inspector Mrs Linda Preen Unannounced Inspection 23rd September 2005 10:00 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 Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 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. Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Red House Nursing Home, The Address Highcross Syresham Brackley Northants NN13 5TJ 01280 850375 01280 850540 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) Miss Denise Weir Miss Denise Weir Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (25), of places Physical disability over 65 years of age (25), Terminally ill over 65 years of age (25) Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th December 2004 Brief Description of the Service: The Red House is set in its own extensive grounds on the outskirts of Syresham village. The home provides accommodation for up to 25 service users over the age of 65 years. Nursing care can be provided as well as personal care. Accommodation is provided in both single and shared rooms, some with en suite facilities. The premises are warm and homely, and extensive redecoration and refurbishment has been undertaken. Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One hour was spent prior to the inspection reviewing previous requirements and recommendations and notifications received from the home. The inspection took place over a period of three and a half hours as part of the statutory inspection programme. Three residents were chosen in order that their experience in the home could be monitored. This included looking at their records, talking to them and also to the staff concerning the care received. In addition to this staff rotas and some policies and procedures were seen. A limited tour of the environment was undertaken. 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. Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 Page 6 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 Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 Page 7 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): 3, 4 Thorough assessments and Terms and Conditions ensure that residents are confident that their needs may be met in the home. EVIDENCE: There was evidence of an assessment procedure in the service user files examined for case tracking purposes. This included pre admission information, and subsequent information obtained on and following admission. The format used was very comprehensive and covered all aspects of service user needs. The care plans examined were noted to be very thorough and explicit, indicating precisely how to meet the needs of individual service users. All service users seen appeared well cared for and appropriately dressed. Those spoken to complimented staff on the standard of care and attention provided. Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 Page 8 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 and 11 Good systems are in place to ensure that all aspects of resident need are identified and documented for staff guidance, to ensure that these needs may be met in the home. Integration of those residents with a diagnosis of dementia does not allow for their specialist needs to be met and also has an adverse effect on the lives of other residents. Guidelines on the care of the dying are not sufficient to ensure that care at this time would meet the needs of all residents in the home. EVIDENCE: Each of the service users identified for case tracking purposes had an appropriate, thorough and up to date plan of care. These were observed to relate to the assessment process, and were precise regarding the actions staff were required to take in each area, with the exception of one resident who had a PEG feed did not have the need for this tube to be turned weekly recorded in the care plan. Residents with a diagnosis of dementia are integrated into the home. There are no specialist facilities or environmental adaptations for this group or separate Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 Page 9 activities arranged to meet their needs. Integration also causes disruption and irritation for the other residents. One gentleman was wandering in and out of other resident’s rooms and lounge areas in his nightclothes and shouting. Another resident became very upset by this and an argument ensued. A recommendation is made in this respect. One relative was in the process of reviewing a residents care plan in conjunction with the nurse in charge at the time of the inspection. Staff were observed to be treating residents with dignity and respect. Residents spoken to stated that the staff were very caring. A policy on the care of the dying is available for staff guidance but this does not include information on the needs of ethnic minorities or non-Christian religions. Inclusion of this information is recommended. Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 Page 10 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): 13 and 15 Residents are enabled to maintain contact with family and friends. Resident’s choice is respected concerning daily activities and also food. EVIDENCE: Service users are able to receive visitors in the privacy of their own rooms. One resident reported that she goes out with family members and enjoys these outings. Another resident stated that they had enjoyed some singers from the community. Records were available of individual choices of food, activities and times of rising and retiring. Service users and staff spoken to confirmed that these choices are acted upon. Service users spoken to confirmed that the standard and variety of food was good and that it was served in adequate portions. Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 Page 11 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 assessed on this occasion. EVIDENCE: Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 Page 12 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, 20, 21, 23, 24, 25 and 26 Residents live in homely surroundings, which are well maintained and clean. EVIDENCE: The home was bright, airy and decorated and furnished to a high standard. Pleasant lounge and dining rooms are provided as well as extensive grounds, which are provided with a range of garden furniture. A range of assisted toilets and bathrooms are available in addition to ensuite facilities in some rooms. Service user rooms seen were clean, well decorated and furnished and showed evidence of personalisation with pictures and ornaments on display. There were appropriate policies and procedures in relation to infection control. The home was observed to be clean and tidy, with no unpleasant odours. Appropriate hand washing facilities were available. Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 Page 13 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 Staffing levels are adequate to meet the needs of the current resident group. EVIDENCE: Duty rotas demonstrated that the numbers of staff on duty appear adequate to meet the needs of the current resident group. One Registered Nurse and 4 carers staff the home in the morning, 1 Registered Nurse and 3 carers in the afternoon and 1 Registered Nurse and 1 carer at night. A large proportion of agency carers are currently necessary but these carers are regularly deployed by the home and are aware of the residents and their individual needs. In discussion the Registered Nurse confirmed that they had enough staff at present but that the increasing dependency of the residents was having an impact on the workload. One member of care staff currently holds a National Vocational Qualification in care and a further 3 staff members are working towards this qualification. In addition to this 4 carers are qualified nurses from overseas. The business manager was reminded of the need for 50 of care staff to be qualified to NVQ level 2 standard by December 2005. Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 Page 14 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): 31, 32, 33 and 38 The Registered Manager ensures that the home is run efficiently, in a way that serves the best interests of the residents. EVIDENCE: The Registered Manager has a number of relevant qualifications, including a professional nursing qualification, a social work qualification and a Diploma in Management Studies. The nurse manager has recently resigned and this post is currently being advertised. One resident spoken to complimented the manager on her care and attention to the residents. Window restrictors are in place where necessary. The premises were secure. Service user files seen demonstrated that Moving and Handling assessments were in place and staff spoken to confirmed that they had received moving and handling training. A piano in the lounge area had a broken corner that was a potential hazard to residents. The business manager undertook to attend to this matter and cover the area until it could be repaired. Health and Safety Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 Page 15 posters were on display and staff spoken to confirmed that they had received COSSH training. Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 Page 16 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 x x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 3 3 x 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x x x 3 Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 Page 17 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 Refer to Standard 11 8 Good Practice Recommendations The policy on care of the dying should be expanded to include guidance on ethnic minorities and non-Christian religions. The home should work towards separating the residents with a diagnosis of dementia in order to ensure they receive the specialist care needed and to reduce the adverse effect this group has on the other residents. The Registered Person should be mindful of the Department of Health timescale in relation to the number of National Vocational Qualified staff required 3 28 Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Red House Nursing Home, The DS0000012653.V253218.R01.S.doc Version 5.0 Page 19 - 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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