Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: The Red House Nursing Home Main Street Maids Moreton Buckinghamshire MK18 1LQ The quality rating for this care home is: The rating was made on: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Barbara Mulligan Date: 0 7 0 8 2 0 0 8 Information about the care home
Name of care home: Address: The Red House Nursing Home Main Street Maids Moreton Buckinghamshire MK18 1LQ 01280 816916 01280 924344 redhousenursing@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Mr Paramjit Sohanpaul The registered provider is responsible for running the service care home 32 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia 0 Over 65 0 Conditions of registration: Date of last inspection Brief description of the care home The Red House is a large detached house in a quiet lane in the small village of Maids Moreton, close to the market town of Buckingham. The home is on three floors with shared and single accommodation. There is a lounge, dining room and conservatory on the ground floor. The home has pleasant gardens, with seating for residents and families. There are public transport links with the local town. There are qualified nurses on duty at all time, supported by a team of care staff. Residents register with the local general practice. Care Homes for Older People Page 2 of 11 What we found:
This random inspection was undertaken due to information recieved about the registered provider. The inspection was undertaken by Regulation manager Sandra Lemon and Regulation Inspector Barbara Mulligan on the 7th August 2008. In addition to this a detailed assessment of the handling of medicines was undertaken by a Commission pharmacist inspector on 13th August 2008. The inspection focused specifically on wound and pressure area care, care planning, safety of medication, staff competencies, payment of agency nurse fees, food provision and other required resources and overall fitness of the provider and manager. Whilst there were a number of areas identified for improvement and requirements and recommendations will be made as a result of this inspection, the service provision does not pose a high level of risk and the outcome for service users was seen to be mainly positive. Verbal feedback was given to the manager before we left the premises to state that CSCI is not concerned about the care practices within the service, however the recording throughout requires attention to evidence the facts. What the care home does well:
Potential service users receive a thorough needs assessment to ensure the home can meet the care needs of the service users. The staff team are well established and have a good overall knowledge of the service users needs. The home operates a named nurse/key worker system that clearly identifies which staff are expected to provide care in specific areas of the home. The home provides a comfortable environment in which people can live. Individuals are encouraged to personalise their own rooms with their own furniture and personal belongings. There is an effective complaints procedure with all complaints and concerns being acted upon promptly, within stated time scales. There is a good range of policies and procedures, providing care staff with relevant information about all aspects of care and the home/organisation. Recruitment procedures were seen to be secure and in line with legislation. The care staff are undertaking relevant training and working towards their National Vocational Qualifications. The manager demonstrated a good knowledge of how the home operates and the needs of service users, she was observed to work positively with her staff team and was clearly involved in all aspects of the day to day running of the service. Care Homes for Older People
Page 3 of 11 What they could do better:
Care plans must contain specific guidelines that detail how staff will meet the needs of people using the service. Care plans must be reviewed by care staff at least once a month and updated to reflect the changing needs of service users. The incidence of pressure sores, their treatment and outcome must be recorded, in detail, in the service users individual plan and reviewed on a continuing basis. The home must ensure that a detailed protocol is in place for the management of epilepsy that provides informative guidelines for the staff on how the condition and needs should be managed and met. One person using the service at the time of the visit was subject to epilepsy and seizures are recorded on file when they occur. However, there is no protocol in place for this individual with epilepsy that provides informative guidelines for the staff on how the condition and needs should be managed and met. This must include guidance for nuses when to administer PRN medication. It was noted that this chart has been updated since the visit on 7th august 2008 and now shows what this medicnes was prescribed for and when it should be given. Complete and accurate records must be kept of all medicines given to people, including the actual dose given if a range is prescribed, any topical preparations that are applied and any dietary supplements that are given. The controlled drugs cupboard did not appear to meet the requirements of the Misuse of Drugs (Safe Custody) Regualtions 1973. The manager must either confirm with the manufacturer of the cupboard that it complies or obtain a cupboard that meets the regualtions. There are no written guidelines for many PRN medicines and this is often left up to individual nurses discretion to administer. There must be clear guidance recorded within care plans for the management of PRN medicines. Care plans do not always identify the social care needs of people using the service or how these needs will be met. This is an area that needs to be improved upon. Staff records are being maintained as required but training records require some attention to evidence up to date data. Recruitment was seen to be secure and in line with legislation but updated evidence of PIN numbers was not available. The homes training matrix was not up to date. Individual training records were examined and show that core training for a number of staff is out of date. This includes fire training, moving and handling, basic food hygiene and first aid and needs to be adressed. All care staff must complete Safeguarding Vulverable Adults training and core training . If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 19 23(1)a The security of the home and 31/10/2007 gardens must be reviewed to ensure that residents have as much freedom as possible whilst minimising the risk that they may come to harm or become lost. Care Homes for Older People Page 6 of 11 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 7 15 The registered person is required to ensure that care plans are reviewed by care staff at least once a month and updated to reflect the changing needs of service users. To ensure the current objectives for health and personal care are actioned. 30/09/2008 2 7 15 The registered manager is required to ensure that the care plans contain specific guidelines htat detail how staff will meetthe needs of people using the service. To ensure that all aspects of the health, personal and social care needs of service users are met. 30/11/2008 3 8 12 The registered person is 30/08/2008 required to ensure that a detailed protocol is in place for the management of epilepsy that provides informative guidelines for the staff on how the condition and needs should be managed and met. Care Homes for Older People Page 7 of 11 To ensure the home promotes and maintains service users health and are able to meet the assessed needs of service users with epilepsy. 4 8 12 The registered person is 30/09/2008 required to ensure the incidence of pressure sores, their treatment and outcome are recorded, in detail, in the service users individual plan and reviewed on a continuing basis. To ensure the promotion of tissue viability and prevention of pressure sores is maintained. 5 9 3 The registered person must 13/11/2008 ensure that all controlled drugs, including Temazepam, are stored in a Controlled Drugs cupboard that complies with the Misuse of Drugs (Safe Custody) Regualtions 1973. To ensure that service users are protected by the homes medication policies and procedures. 6 9 13 The registered person is 30/08/2008 required to ensure that complete and accurate records are kept of all medicines given to people, including the actual dose given if a range is prescribed, any topical preparations that are applied and any dietary supplements that are given. To ensure that service users are protected by the homes medication policies and Care Homes for Older People Page 8 of 11 procedures. 7 9 13 The registered person is 30/08/2008 required to ensure that clear guidance is recorded within care plans for the management of PRN medicines. To ensure that service users receive the medicines they need and are protected by the homes policies and procedures. 8 12 16 The registered person is 30/12/2008 required to ensure that care plans identify and record the service users interests and demonstrate how these needs will be met. To ensure the home can meet the social, cultural, religious and recreational interests and needs of service users. 9 18 13 The registered person is required to ensure that all staff complete Safeguarding Vulverable Adults training. To ensure service users are protected from abuse. 10 29 19 The registered person is required to ensure that updated evidence of PIN numbers is available in staff files. To ensure service users are protected by the homes recruitment policy and practices. 11 30 18 The registered person must ensure that core training is up to date for all staff. To ensure that staff are 30/01/2009 30/09/2008 30/12/2008 Care Homes for Older People Page 9 of 11 trained and have the skills necessary to meet the needs of service users. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 2 3 7 8 8 It is strongly recommended that the daily notes are written legilbly. It is strongly recommended that healthcare screening is recorded in detail, in care plans. It is strongly recommended that the home provides pressure relieving equipment, necessary, on armchairs and wheelchairs. It is recommended that meal times are better organised, to enable staff to spend more time providing support for service users with eating and feeding. 4 15 Care Homes for Older People Page 10 of 11 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 11 of 11 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
