Inspection on 04/07/05 for The Red House Nursing Home

This inspection was carried out on 4th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Red House Nursing Home 23/05/07

The Red House Nursing Home 12/10/06

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 Jenny McGookin Announced 04 July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 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 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 redhousenursing2@tiscali.co.uk The Red House Nursing Home Limited Mrs Susanne Elizabeth Williams Registered Care Home with Nursing 31 Category(ies) of Care Home for Older People, Older People, 31 registration, with number and E over 65 but not old age, 8 of places The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25/05/05 Brief Description of the Service: The Red House Nursing Home is registered to provide nursing care for up to 31 older people over the age of 65.This nursing home is a large detached building, which used to be a Victorian vicarage, set in attractive and well-maintained gardens. It has two lounges and a dining room, which can accommodate 10 users at a time. Seventeen of the twenty-three single bedrooms are en-suite and all shared rooms have en-suite facilities. There is a call bell system, television and telephone point in every bedroom. The Home has a shaft lift and there is easy access for wheelchair users. In terms of access and scope for community presence, The Red House is set back off a roundabout on Rheims Way, within walking distance of bus routes. It is approximately 1.5 miles from The Westgate, the cathedral and Canterbury city centre, with all the community resources and transport links that implies. The Home has on-site car parking facilities, for 13-14 vehicles. The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which was used to check progress with matters raised from the last inspection (May 2005,) accepting that a number of timeframes had yet to run their course; and to reach a preliminary view on other aspects of the day-to day running of the home. The inspection process took just under fifteen hours, spread over two days, and involved meetings with four residents, three relatives / representatives, three staff and the manager and the deputy manager. The inspection also involved an examination of comment cards from eight residents, records and policy documents and the selection of two residents’ case files, to track their care. Five bedrooms were inspected for compliance with the National Minimum Standards, and the inspector also checked some communal areas. Interactions between staff and residents were observed throughout the day. What the service does well: What has improved since the last inspection? What they could do better: The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 6 While some residents are clearly content with their life at this home, others require support adjusting to nursing care and some have said they would like more activities. There needs to be a system for reminding residents of menu choices available to, or made by, them. Findings in May 2005 in respect of care plans still apply. Care planning reviews should routinely record who participates in each case; include the recorded views of resident and/or their representative, and any unmet needs, so that anyone authorised to inspect them can evaluate their ownership. More attention could be given to exploring each resident’s interests, aspirations and social needs in a practical way. A more holistic, inclusive approach is required. The introduction of an activities co-ordinator should be of demonstrable benefit. Visits by the proprietor or delegated officer must be undertaken in full compliance with regulation 26; and reports need to identify which records, rooms and individuals are involved in each case, so that anyone authorised to inspect the records can judge compliance with the standard. All bedrooms should have lockable doors (accessible from the outside in the event of emergencies) as standard; and the equivalent of two double electric sockets (ideally sited three feet from the floor so that residents can access them without stooping or having to seek staff assistance). Some matters were raised in respect of policies, and it is recommended that staff be required to confirm having read and agreed to comply with policies with their signatures and date. 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 Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 5, 6 1. The home has a Statement of Purpose and Service User Guide but they do not provide Service Users and prospective Service Users with all the information they need to make a decision about moving into the home. 2. There are contracts governing each placement between the home and the resident, or their representative, and between the home and any placing authority. 3, 4. Prospective residents are assessed prior to admission to establish the extent to which their needs can be met by the home, and how potential risks will be managed. Service users are content with the way they are supported by the home. 5. Prospective residents, or their representatives, have the opportunity to visit the home before proceeding with the admission and there is a trial stay to further inform their choice. 6. The home does not provide intermediate care. EVIDENCE: The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 9 There is a Statement of Purpose and Service User Guide, which usefully describe the facilities, services and principles of care but at the last inspection (May 2005) a number of elements listed by this standard were not there. The home has until 30 September to obtain full compliance with this standard. Feedback on the day of this inspection indicated that the decision to apply to this home was influenced more by its locality (i.e. close to where the resident or their friends or relatives lived) and by personal recommendation, or through having visited other people there, than by any public information produced by the home itself. There are contracts governing each placement (whether self funded or social services funded), which are identical except in respect of the arrangements for the payment of fees, termination of placements and signatories. At the last inspection (May 2005) some recommendations were made to improve the contract documents. These matters still stand. See schedule of recommended action. Most referrals are, in the first instance, made by word of mouth. If there is a vacancy, prospective residents of their representatives will be sent a colourful brochure (the photographs are currently being updated for future editions). Before the home carries out a preadmission assessment, the prospective resident or representative are invited to visit the home, and meet the staff. One resident was able to confirm this. Others said they saw no need to, either because they trusted the judgement of their representatives or because they had visited people there before and gained a positive impression of it. Two recalled the manager and proprietor carrying out an assessment resident to make sure the home can meet their needs, though more recently the deputy has become involved in this process. Records confirm there is a standard preadmission assessment form to ensure a consistent approach. At this stage, understandably, there is a clear nursing bias in the assessment. . Each resident is offered a trial stay, which can be anything from a weekend to a week, although the manager said that in practice 99.9 are so frail they come to stay. Residents and relatives confirmed this was the practice. On their admission, the home carries out another assessment, which also starts to take into account social care needs. The manager said the home does not provide intermediate care. The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 7. The assessment and care planning processes cover a wide range of health and personal care needs, as well as some social care needs 8. The home is served by a range of healthcare professionals, to promote good health and has adequate facilities for privacy. 9. The systems for medication administration are good, with clear and comprehensive arrangements being in place to ensure Service Users medication needs are met. These arrangements include scope for residents to administer their own medication, subject to risk assessments. 10. Residents confirmed that staff treat them well, and that their privacy is respected. EVIDENCE: The situation as found on the last inspection showed no changes. The preadmission assessment is a summary document, which covers the most critical health and personal care needs. This is then developed into a second tier assessment document, which addresses some social care needs (e.g. preferences, social and familial The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 11 contacts, hobbies and interests, important life events), and is intended to be read in conjunction with care plans and “family tree” information, though work on the “family tree” has not been completed. An examination of two residents’ files, followed through with discussions, generally confirmed the practice as described. The care planning process starts on the first day of admission, and records confirm care plans are reviewed monthly – usually by a trained nurse. However, records of reviews still showed no change overall, and there were gaps in the records in respect of reviews and follow up in respect of social care needs (interests, activities). This was a matter raised at the last inspection. The manager said there is no formal group review of care plans other than those led by care managers, and none of the residents or carers spoken to showed any recognition of an active care planning review process. But they did generally recall being asked questions about their care needs right at the start. And they also confirmed the manager’s own assertion that she was always available to residents or their relatives to discuss any issues or concerns. One resident confirmed having been offered the opportunity to administer their own medication, and there is a policy covering all aspects of medication acquisition, storage, administration and recordkeeping as well as its safe disposal. Most bedrooms in this home are single occupancy, which means personal care and treatments can be given in privacy. Shared rooms have screening to afford occupants some privacy. Feedback from the residents confirmed that their privacy was respected and that staff generally treated them well, though there have been occasional minor lapses, attributed to what they perceived as staff shortages and competing pressures and priorities. The home accesses a range of healthcare professionals, but residents would need to pay for chiropody, physiotherapy of any special or private treatment or medication themselves. If the home needs further nursing advice it can use the District Nurses, and the home is served by seven GP practices, so individuals have some choice. The home has yet to fully instigate a key worker system – this is expected to become easier once staff are NVQ trained. The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 12. Most residents are generally content with their lifestyles in this home, and the home has been able to match their expectations. This home offers a limited range of activities inside and outside the home, but there is no activities programme and some residents would like the home to organise more activities. 13. There are open visiting arrangements, and the home is well placed for access to local shopping outlets as well as Canterbury City itself 14. There is choice and control over most aspects of daily routines. Personal care is offered in a way which protects residents’ privacy and dignity. 15. The meals in this home are generally satisfactory, offering both choice and variety and catering for special diets. Residents can also opt to eat where they and at different times. But there needs to be a system to remind residents of menu options available to, or already made by them. EVIDENCE: The situation as found on the last inspection (May 2005) showed little change. As before, residents were not able to give many examples of any particular interests and hobbies being promoted by the home. Most indicated that they were generally content with their lifestyles in this home, others wished the The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 13 home would organise more activities. The planned introduction of an Activities Co-ordinator should be of benefit. There is communion once a month for Anglicans and a representative comes from the Roman Catholic Church every Tuesday. The Statement of Purpose states that the home is visited by representatives from all denominations but there was no information on how to access other religious services. The home has open visiting arrangements, and meals can be provided if required at nominal cost, though this did appear to the residents or relatives spoken to on this occasion. The daily routines are as flexible as healthcare needs will allow. With one exception (due in part to the resident feeling she had committed herself at the very start) residents confirmed that they can choose when to get up and go to bed. They can choose where to take their meals (though there is an attractive dining room, which can accommodate ten residents in each sitting), and also have some choice over meal times. Plated meals are kept for them in the fridge. Less clear was their understanding of the menu choices available to them. There was no system to remind them. A farm shop visits every other day. The home gets all its meat from a local butcher in Wincheap. Residents are given wine or beer with their meals at no extra charge. The home is keeping records of the meal options actually consumed by individuals, as required. Five residents confirmed they enjoyed the meals, five others said they did sometimes, in one case the resident felt they varied according to who prepared them. One felt they had too much tinned fruit and packaged food, and one other said that specific requests such as particular sandwich fillings or a banana at supper had not been met. Most residents were not aware of the menu choices available to them. The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 16. There is a complaints procedure readily available, and residents feel that any complaints they had would be listened to and acted on. The home relies on staff, or the residents’ families and friends to raise issues and represent the interests of the less able residents. 18. Residents feel well cared for and safe there is a policy on adult protection. Staff have gained a sound knowledge and understanding of adult protection issues and a commitment to protect residents from abuse EVIDENCE: The home’s complaints procedure is detailed in the Statement of Purpose and Service User Guide, and describes the process and timeframes involved, in general compliance with the provisions of Regulation 22. However, it gives the CSCI as an option only “if you feel your complaint has not been dealt with properly or you wish to take the matter further”. This is not a correct interpretation of the National Minimum Standard or Regulation 22 and the last inspection in May 2005 gave the home till 31st August to correct all copies. The residents confirmed that they would know who to talk to if they had a complaint and felt safe. The home does not use any independent advocacy services but relies on staff, or the residents’ families and friends to raise issues and represent the interests of the less able residents. There is a policy on abuse, and the manager is conversant with all the available sources of advice; the agencies, which need to be involved and the need to take a multidisciplinary approach to strategy meetings, to ensure a The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 15 timely and cohesive approach. All the residents spoken to on this occasion said they felt safe at this home. The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26 19, 25. The layout of this home is generally suitable for its stated purpose, and residents confirm this is an attractive and homely place to live. Records confirm it is being maintained and regularly inspected for safety. 20. Residents have a choice of communal areas, and furnishings tend to be domestic in character. There are homely touches throughout. 21. Lavatories and washing facilities are generally accessible to bedrooms and communal areas. 22. There is a range of equipment and adaptations to support residents and staff in safety in their daily routines and to maximise residents’ independence. 23, 24. Most residents have access to the privacy of their own bedrooms and a number of rooms have en-suite facilities. Residents can personalise them with their own possessions and items of furniture 26. The home is generally well maintained and all areas inspected were free of any unpleasant odours. The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 17 EVIDENCE: The layout of this home is generally suitable for its stated purpose and well maintained and decorated. Some matters were raised for attention on this occasion. There are 23 single bedrooms, which are all at least 10 square metres – 14 of these have en-suite facilities. There are two shared rooms, which are at least 16 square metres and two shared rooms, which are below the National Minimum Standard of 16 square metres. All four shared rooms have en-suite facilities. Five bedrooms were assessed against the National Minimum Standards and generally had all the furniture and fitments required. All were well maintained and in satisfactory decorative order. Each room had been personalised with the residents’ possessions and, in some cases, pieces of their own furniture and there were homely touches throughout. Although several residents said they did not want locks on their doors or any lockable facilities these should be available as standard. There are four communal bathrooms, including one Jacuzzi and shower facility on the ground floor i.e. so that residents have a choice and all are within reasonable access to bedrooms and communal areas. The home has two commercial washing machines with sluice cycles, one dryer and three separate sluice areas. Clinical waste is appropriately managed – there are collections every Thursday under contract by Canterbury City Council. The home provides adequate communal space for each resident. There are two lounges (one of which is known as the “Quiet Room” and has a library which is kept replenished by Canterbury library) and a dining room. All furnishings within the communal areas are domestic in character and of good quality, suitable for the service users needs. All areas seen were clean, well maintained and in satisfactory decorative order. At the last inspection, an unsightly stain was noted on the ceiling of the Quiet Room. The entire room was redecorated soon afterwards. The Home has a shaft lift to access all floors and all areas are linked with a call bell system. Specialist equipment includes special mattresses, raised toilet seats, grab rails and corridor rails, slip mats, handling belts and slide sheets There are two hoists in place though one is scheduled to be replaced by a new hoist on order. Two bathrooms have their own hoists. Access to the front door and patio is good and there are handrails. The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 18 There are several storage areas located around the building and outside the property, but some areas (clinical and sluice) were found to be a bit cluttered. Certificates confirm this home has been awarded “Clean Food Awards” by Canterbury City Council Environmental Health department virtually every year from 1994 till 2003. The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30 27. There is a detailed staffing statement, based on the number of residents and their dependency levels, so that their needs can be met. This is a workforce which reports working flexibly and co-operatively to maintain the residents’ quality of life. 28. Residents feel safe and well cared for. Mandatory health and safety training is in train, although cycles have yet to be completed. Positive relationships, which have been formed between the staff and residents. 29. There is a systematic recruitment process, which includes a range of checks, to protect residents. 30. Staff are multi skilled to ensure good quality care and support. Considerable progress has been made with the introduction of training and appraisal systems to oversee and manage further skills development, but it is too early to judge the effectiveness of these systems yet. EVIDENCE: The following staffing levels are in place, based on the numbers and dependency levels: The working day is from 8am till 8.30pm i.e. 12.5 hours. The manager and her deputy work from 8am till 5pm. During the morning shift there should be 2 trained staff (including the manager or Deputy) and one RGN - plus 5 care assistants till 1pm. During the afternoons, there should be the manager or deputy or RGN till 4/5pm plus one RGN who is then on his/her own from 4pm till 8.30pm - plus 3 care assistants. Within this arrangement, some individual The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 20 shifts are staggered, but the overall numbers and ratios of nursing / carer staff is maintained. There are 2 cleaners and a housekeeper every day. The manager feels this is a satisfactory arrangement, but some residents said they felt staff were not always as readily available as they would like (e.g. in the mornings as residents are being assisted to get up or at meal times); that they sometimes appeared hurried; and that there had been occasional lapses in care standards, which may indicate the need for further review. At the same time the same residents spoke fondly of the staff, and said they were like family members to them. The manager is able to negotiate changes with the registered proprietor as necessary. Records and staff confirmed a systematic recruitment process, designed for consistency, and diversity (see below). Staff confirmed that their recruitment was subject to satisfactory references, identification and CRB checks. Equal Opportunities Four care staff are male, which means that same-gender care can generally be given. The manager said that if a female resident objected to a male carer giving care, another carer would be sent in. With one exception all the residents are white British. The staff group is culturally diverse. The registered proprietor herself is Kenyan by birth. Other nationalities represented on the staff group include Kenya, Nigeria, Philippine, Indian as well as white British. The manager said that all staff are required to have an adequate command of the English language as a condition of their employment. Training and appraisal The manager said that 5 staff have completed their NVQ2. One member of staff will need to re-do her training; others have moved on. The home has now engaged with Learn-Direct for ongoing training. Several staff have had induction, and there is a matrix and cycle of mandatory training on issues such as manual handling training, infection control, First Aid, and fire safety training etc. A programme of staff appraisals has been drawn up. The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36, 37, 38 31, 32. The Manager’s qualifications and experience as described are appropriate to her role as registered manager, subject to her completion of NVQ4 accreditation or its equivalent. Residents and staff have confidence in her leadership qualities. 33. Feedback questionnaires indicate that the views of residents or their representatives are now being systematically sought and used to measure the home’s success in meetings its own aims and objectives as well as the residents’ expectations. 36. Progress has been made with the introduction of a cycle of staff supervision, but it is too early to judge the effectiveness of this system yet. Staff confirm day to day interaction with their line managers to maintain satisfactory standards. 37. Staff have access to a comprehensive range of policies and procedures and records are up to date and stored appropriately The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 22 38. All health and safety checks are maintained and in good order. EVIDENCE: Some progress has been made with the manager’s application for NVQ4 accreditation, since the last inspection in May 2005, and she is due to start her Registered Managers Award training in September. Mrs Williams has been running care homes for over twenty five years and has spent the last nineteen years managing the Red House. There are clear lines of accountability within the home, and the home has a good record of staff retention. A satisfaction survey was carried out at the beginning of July to establish how residents or their representatives felt about nursing care standards; the attitude of staff; food, laundry and cleanliness; and facilities of the home (grounds, maintenance and décor, activities and overall impressions). This initiative had only generated a few responses to date, but taken in conjunction with the CSCI’s own comment cards and feedback on both inspections this year, indicated a generally high level of satisfaction with the services provided by this home. With one exception, residents do not appear to want to be any more involved in decisions about the running of the home than they already are. The arrangements for managing residents’ finances were not inspected on this occasion, as families and other parties outside the home’s control have responsibility for this. A cycle of formal documented staff supervision sessions has now been introduced, but it was too soon to judge the effectiveness of this. However, staff confirmed that they have ready access to their line managers for advice and support, and feel well invested in, in terms of training opportunities. Staff and residents expressed confidence in the manager’s leadership style. The home has a comprehensive range of policies and procedures and records indicate these are subject to periodic review, to maintain their currency. Maintenance records inspected were up to date and backed up with periodic environmental risk assessments. At the last inspection, the manager was asked to obtain guidance from the fire safety officers on its practice of wedging open fire doors and this was obtained – a number of conditions were imposed. The home has a Business Plan for the financial year 2005/6 which usefully describes the market and competitive forces, income and growth potential. There were no Regulation 26 reports on monthly visits by the proprietor or delegated officer. The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 3 3 3 2 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 2 3 3 x x 2 3 3 The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 24 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 OP1 Regulation 4 & Sch 1 Requirement The Statement of Purpose must be amended to comply with all the elements of National Minimum Standard 1, Regulation 4 and Schedule 1. The Service User Guide must be amended to comply with all the elements of National Mimimum Standard 1, Regulations 5, 6. The complaints procedure needs to be amended to advise prospective complainants that they can refer their complaints to the CSCI at any stage if that is theoir preference. The fire officer must be asked to assess the safety of wedging fire doors open. Bedrooms. The following matters require attention: Room 1. Lights over bed and sink not working and require repair or replacement. One drawer handle requires replacement Room 3. The resident must be able to access the bedside light cord on wall Room 5. Resident finds bed too high to get into. The resident requires ready access to a mirror Timescale for action 30/09/05 2. OP1 5, 6 30/09/05 3. OP16 22 31/08/05 4. 5. OP19 OP24 23 16(2)(d) 31/08/05 31/08/05 The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 25 6. OP26 12(1)(a) 7. OP26 12(1)(a) 8. OP31 26 Room 9. Requires the equivalent of two double sockets Room 10. Requires the equivalent of two double sockets. Room 23. One double socket was behind bureau i.e. requires making accessible 31/08/05 Clinical area. No items should be stored at floor level or on work tops. This facility needs a bigger area or another cupboard. Sink and sink surround is stained and worn. The sink should have either wrist or elbow mixer taps Sluice area. No items should be 31/08/05 stored at floor level. Ceiling was stained and will require redecoration. Worktops and shelves must be kept clean / stain free The registered provider must 04/07/05 carry out visits to the home in full accordance with the provisions of Regulation 26 and submit a written report to the CSCI in each case so that compliance can be judged 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. Refer to Standard OP2 Good Practice Recommendations Placement Contracts (privately funded and social services funded). The following elements are recommended to comply with standard practice· - Both contracts should identify the circumstances which would warrant serving of notice- Both contracts should detail all the services provided by the home – personal care, heating, lighting, activities. including snacks between meals - Both contracts should detail safekeeping arrangements (access to the safe, H&S / PAT tests and insurance cover H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 26 The Red House Nursing Home 2. OP7 3. 4. OP12 OP16 5. OP19 arrangements, medication)- Both should undertake to comply with the provisions of the Care Standards Act 2000 and National Minimum Standards, including provision and review of care plans Care Planning reviews should routinely record who participates in each case; include the recorded views of resident and/or their representative, and any unmet needs, so that anyone authorised to inspect them can evaluate their ownership. More attention could be given to exploring each resident’s interests, aspirations and social needs in a practical way There should be an activities programme and some residents would like the home to organise more activities. The home will need to demonstrate that not only do residents and other interested parties know how to make complaints but are actively assisted to do so i.e. though independent advocacy services. Building. The following matters should be given cosnideration: External door opposite kitchen. Recommend handrails alongside ramp if residents likely to use unaccompanied. Day Room. Recommend Loop system is considered Bathrooms and WCs – recommend homely touches to make less clinical. External windows should have blinds or curtains to make more homely and guarantee privacy Obvious commodes should be replaced by more discreet models. The Red House Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 27 Commission for Social Care Inspection 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Nursing Home H56-H05 S26112 Red House NH V225981 040705 Stage 4.doc Version 1.40 Page 28 - 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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