Inspection on 22/11/05 for The Red House Residential Carehome

This inspection was carried out on 22nd November 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 14 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Red House Residential... 17/12/07

The Red House Residential... 05/10/07

The Red House Residential... 17/10/06

The Red House Residential... 24/05/06

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 The Redhouse Residential Carehome 5 Conygre Road Filton South Glos BS34 7DA Lead Inspector Odette Coveney Unannounced Inspection 22nd November 2005 09:00 The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 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 Redhouse Residential Carehome DS0000065123.V261865.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Redhouse Residential Carehome Address 5 Conygre Road Filton South Glos BS34 7DA 01454 774949 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) Mr Heron Moodie Mrs Teresa Margaret Hassell Care Home 8 Category(ies) of Learning disability (8) registration, with number of places The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 8 persons with Learning difficulties, aged 1864 years requiring personal care only. 26th May 2005 Date of last inspection Brief Description of the Service: The Red House is registered as a private care home, and provides accommodation for eight adults with learning disabilities. The home is located in the South Gloucestershire region in the residential area of Filton. It is near to the main arterial road leading north from Bristol, which connects the main M4 and M5 motorways. It is close to a range of shops, a post office, library, pubs and Filton College. There is a GP surgery and Optician within close walking distance. It is close to the bus routes that go into Bristol, a journey of approximately three miles. The Red House is a large, mature, detached Victorian two-storey house of red brick construction, the house name was chosen by the original group of residents. There are two large communal areas, two single bedrooms and a staff room on the ground floor, with six single rooms on the first floor. Each bedroom has a vanity unit to provide en-suite washing facilities. There are gardens surrounding the house, with a range of mature trees, shrubs, a pond, and flower and vegetable beds. The garden is fully wheelchair accessible, and there is also a greenhouse and a summerhouse, which are widely used, in the warmer months. The laundry facilities are sited away from the main house in the garage. A wide range of leisure activities are available for residents, and the home has a large display of photographs which record activities and significant events. The home has a people carrier for outings and holidays. The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted as part of the annual inspection process to examine the care provided, and to monitor the progress in relation to the five requirements and two recommendations from the last inspection that was conducted in May 2005. The inspection took one day to complete. During the process all of those living at the home, three staff and a day services support worker were spoken with. The inspector looked around some of the building and a number of records were examined. Since the last inspection there have been a number of significant changes. The home now has a new registered provider, Mr Moodie who was formally a ‘silent’ partner in the company. The deputy manger has left the home, and the registered manager is currently working out her notice. A new manager has been appointed however a date for their commencement at the home is unclear. What the service does well: What has improved since the last inspection? At the previous inspection two residents shared a room, this is no longer the case as the home has made the large room into two smaller single rooms. Staff commented that this has had a positive impact on the quality of lives for both of the individuals concerned in respect of improvement in sleep pattern and lessened levels of anxiety. The home has demonstrated a commitment to ensuring that residents are protected from the potential of abuse and has evidenced that individuals have been appropriately supported by ensuring that the support workers employed at the home have attended Protection of Vulnerable Adults training, by completing regulation notification notices and informing the Commission of The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 6 incidents what have affected the well-being of individuals at the home and by also completing a fully comprehensive risk assessment covering all aspects of resident holidays. Access to the rear garden for residents has improved now that a handrail has been fitted. What they could do better: Two of the five requirements made at the previous inspection have not been met. One of the two recommendations has not been met. An immediate requirement was made on the day of inspection, which required that the home must undertake a review of the staffing arrangements in order to ensure that the needs of all are met. In order to ensure that residents’ needs are being met and monitored on a regular basis it is required that the home ensure that all care plans are reviewed on a regular basis. Consideration should also be given to the appropriate use of language and terminology within daily care records. In order to ensure that residents are fully protected and safe and also to demonstrate that staff are aware of their role and responsibility it is essential that the home update their adult protection policy and procedure, that the registered provider must undertake the Protection of Vulnerable adults training. It is further required that a review of security at the home is undertaken, ensuring that monies held on residents behalf for safe keeping is secure in a lockable facility. The home would be better placed to meet the Care Homes Regulations 2001 if regulation 26 visits were undertaken and if the reports were forwarded to the Commission for Social Care Inspection. If they are completed fully and legibly the Commission would have a clearer view of the day-to-day management and running of the home. Resident’s safety would be further improved if the home developed a lone working policy for staff, if medication records were completed fully, if the home ensured that staff receive sufficient fire safety instruction, that the necessary fire safety checks are consistently being undertaken and if the homes risk assessment on fire included what the procedure is at night. The environment in which residents live would be improved if residents were consulted on whether they would like to be able to lock their bedroom doors and also if attention was given to the poor television reception in a residents rooms. In order that any potential new residents to the home are fully aware of the aims, objectives, services, facilities and the staffing arrangements at the home The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 7 the statement of purpose should be updated in order to reflect the current management status. 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 Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 Prospective residents needs and aspirations are fully assessed and they know that the home is able to meet these, however the statement of purpose requires updating in order to reflect the current management status at the home. EVIDENCE: The statement of purpose that was in place at the home was fully comprehensive and outlined the aims and objectives of the home, the services able to be provided and the facilities available to residents. The document also provided information about the qualities and skills of the support staff. Information was included about the management of the home and included details of the new registered provider. The document however made reference to the deputy manager who has since left. The current registered manager is also leaving the home and a replacement has been appointed. It is recommended that the statement of purpose be updated to include the current management status of the home. The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 10 It was evident that the home had initially liaised with the individual, their family and professionals during the assessment process and that the information received during the admission and assessment period enabled the home to develop care plans, these were in place for all individuals living at The Redhouse. Information had been gathered over a long period of time and the inspector saw that the plans in place had been tailored to the specific needs and expressed wishes of the individual. Two of the residents at the home are in the process of moving out. It was clear that both of the individuals have been supported through a multi-disciplinary approach with agencies working together to ensure that individual’s needs are met. The home is clear about the services it is not able to provide and when individual’s needs at the home are not being met. When an alternative placement has been found correspondence was seen from the manager who has advocated on behalf of individuals at the home in order to ensure that other professionals are given full information of the diversity of individuals needs. The manager has also been involved in providing information to others in order to facilitate a smooth transition for the individuals who require alternative care. One of the residents has visited another home and has arranged to have an overnight stay to determine whether the home is able to meet the person needs. The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Individual’s health, personal and social needs are well met, recorded and reviewed on an ongoing basis. Medication recording systems must be improved. Support is delivered in a manner to ensure individuals’ respect and dignity, however care plans must show that they are reviewed. EVIDENCE: It was evident that the registered manager and staff members had developed with each resident an individual care plan, these records clearly showed that the resident had been at the centre of the process and reflected individual choices, routines and needs with further information recording how the care home would meet these needs. Records were very detailed and included information on how individuals wish to be supported in both a practical, physical and emotional way in areas such as health, social care and relationships. One of the residents has a high level of support and this was clearly evident and well recorded within their care records. Of the eight care plans two had not been reviewed or updated for some time. It is required that care plans are reviewed on a regular basis in order that individuals static and changing needs are identified and met. It was noted that in one resident’s care The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 12 records disrespectful terms were used to describe them. It is recommended that consideration should be given to the use of language and terminology used within resident’s records, that information should be factual, not personal opinion. Two of the residents at the home are currently being supported by the home and also by external agencies in order to look for a more suited environment. It is anticipated that this will be a home, which is able to provide nursing care and a supported housing environment for a more independent way of living. Both individual’s needs and wishes have been considered and where able individuals have been consulted. Where it has been difficult for a resident to verbalise their opinion decisions made have been done so in consideration of what would be in that person’s best interests. The inspector saw and heard staff communicating with individuals asking them their opinion and offering choices. Evidence that individuals are offered and encouraged to make choices in aspects of their lives were well recorded within care documentation. Residents told the inspector that they had been consulted and are asked to give their opinion on an informal basis and also during general house meetings. The home has developed comprehensive risk assessments, which have been produced within a risk management framework, without impacting on individual’s expressed choices, all of these were relevant to individuals lives and had been recently reviewed to ensure that information held was current. The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, Social activities and community presence are well managed, tailored to the specific wishes and abilities of the individuals, these are creative and provide daily variation and interest for the people living in the home. EVIDENCE: All of those in the home have learning disabilities. The information seen within care records demonstrated that individuals are encouraged to participate where appropriate in making choices and decisions upon day-to-day issues which affect their well being. At the time of the inspection all of the residents with the exception of one who was unwell were out attending resource centres and local groups. In the afternoon two residents were supported by a staff member to attend church, another resident walked to the local shops, upon their return showing the inspector their purchases. Other residents in the home told the inspector about the holiday they had enjoyed earlier in the year. At the previous inspection the home were required to complete a risk assessment covering all aspects of residents holidays. The inspector saw that this had been completed and a full The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 14 and detailed assessment had been completed that covered many areas of identified risk factors and how these could be overcome. During the inspection a day care support worker visited a resident who had not attended the activity centre for a while due to their ill health, they told the inspector that they were always made welcome at the home and that individuals appeared to be well cared for and happy. Good rapport was seen betweeen this support worker and staff at the home with both demonstrating a sound understanding of the changing needs of individuals. Evidence in care records showed that staff support residents to become part of and participate in, the local community in accordance with assessed needs and individuals’ wishes. Staff have helped residents with their integration into community life through making use of local facilities and activities such as shops, pubs, leisure centres and places of worship. Activities and outings are organised in accordance with individuals expressed wishes. The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 The social, physical, emotional and healthcare needs of individuals are well met with the relationships between those living at the home and staff being well established. EVIDENCE: The care documentation for four individuals living at The Redhouse was viewed. Records were on the whole very comprehensive and reviewed on a regular basis. Care plans incorporated individuals likes, strengths, dislikes and needs. Aspects of support including activities of daily living, social, emotional and personal care support were all well recorded. Clear guidelines are in place with care documentation on individuals preferred routines and choices. The health needs of individual’s are well met with evidence of good multi disciplinary working taking place on a regular basis. All of those living at the home are registered with a general practitioner; evidence was in care records to confirm that individuals are supported with their primary healthcare needs such as optician, dentist and chiropody. Other specialist services are contacted when an identified need arises such as physiotherapy. One of the residents at the home has a high level of support needs. The staff are to be commended for the level of support and care that the person receives. Records are maintained of fluid and food intake and the staff team is monitoring this closely in order to ensure that individual’s dietary requirements are being met. The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 16 There are clear medication procedures in place in order to guide staff practice, however these are not being fully adhered to as medication records had not been fully completed and there were a number of occasions where records had not been signed. It is required that medication records must be fully completed. One resident self medicates and has a lockable facility in their room to support them to maintain their independence in this area. The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Residents are not sufficiently protected from abuse and polices in place do not provide correct information. EVIDENCE: A requirement was made at the last inspection that staff members must undertake Protection of Vulnerable Adults training, staff spoken with confirmed that they had undertaken this. One staff member told the inspectors of the course content and the differing definitions of what constitutes abuse. Mr Moodie has been a ‘silent’ partner of the business, earlier this year Mr Moodie underwent the ‘fit’ persons process and a condition of his registration was that he must undertake protection of Vulnerable Adults training, this has not yet been undertaken and therefore the requirement was again made at this inspection. The home has in place an adult protection policy and prevention of abuse document, this document provides clear definitions of who abuses and what course of action the home would undertake should an incident be reported to them. However, the document must be updated to include the arrangements for contacting the Social Services department as it is them who would take the lead in any investigation and would make the decision on the most appropriate course of action, not the home. During the inspection three areas of concern in respect of security became apparent during the day. The back door was left open and medication keys were kept in the cabinet, making access to both the home and medication easy for an opportunist. The third area of concern was relating to monies being held for safekeeping for the residents. Upon examination of records and cross The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 18 checking this with money held two residents money were not correctly accounted for ones residents money was ten pounds short, another sixty pounds. A staff member was able to account for the sixty pounds, however the other money was still unable to be accounted for. Money held for residents safekeeping is held in a drawer that is unable to be locked. It is required that a review of security within the home is undertaken and also that monies held on behalf of residents must be stored in a lockable facility. A resident said that if they had any complaints they would speak with the manager; they said they were happy and had no problems. The inspector was unable to view the complaints logbook, as this was unable to be located at the time of the inspection. This has been viewed on previous inspections. The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28, 29, 30 The Redhouse is a comfortable, homely environment. Significant improvements have been made to ensure the privacy of individuals within the home, however improvements are needed in this area also to ensure individuals security and the effectiveness of equipment, which has been provided. EVIDENCE: The location and layout of the home is suitable for its intended purpose. The home is a large detached house with accommodation set over two floors. There have been some changes in the facilities provided at the home since the previous inspection. Since the home opened there has been a double room in which two people shared. Since the last inspection building work upstairs has created two individual rooms, each with a wash hand basin. Both residents were involved in choosing the décor of their new rooms with new carpets and fixtures being provided. A staff member commented that the creation of two rooms has improved the quality of life for both individuals concerned, including a better nights sleep, privacy and their own personal space. These rooms were seen to be an improvement in the environment provided at the home. The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 20 Individual’s rooms had been personalised to reflect their personal taste, age and preferences, rooms were seen to be well furnished. Communal areas are well maintained, homely and comfortable. It was noted that none of the residents are able to lock their own rooms. Staff confirmed that residents had never been asked if they would like a key to their room. One of the residents spoken with said they would like to be able to lock their room for security and privacy. It is required that residents must be consulted as to whether they would like to be able to lock their own rooms and their decisions should be recorded within their care documentation. Within resident’s rooms were their own personal effects, music systems, artwork and photographs. It was found that the television reception in one of the residents rooms was poor, it is required that this be addressed. There are some aids and adaptations throughout the premises, including wheelchair access to the front and rear of the house, there are toilet aids, continence aids, various grab rails and an emergency call bell system. It was seen in care records that an individual has received information and support from the physiotherapy and community learning disabilities team and specialised bedsides and a pressure-relieving mattress had been obtained for them in order to make sure they were comfortable and safe. A requirement was made at the last inspection that the home fit a handrail by steps, which lead out to the rear garden; this has been completed making the garden more accessible to those with mobility difficulties. The home was clean and tidy; staff are to be commended for this as no domestic staff are employed at the home. Residents are supported and encouraged to participate in activities of daily living such as ironing, preparation of drinks and snacks and general tidying. The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 There is an effective staff team at the home, who have a clear understanding of their role and responsibilities. EVIDENCE: Each individual at the home has a key worker to support them with the manager being involved with the monitoring of individual care. It was clear that staff have developed relationships with individuals and have worked together with them and others in order to, identify the needs of the individual and then support their key client in achieving their goals and future aspirations. There was information in individual’s care plan documents and person centred planning information to guide staff to the appropriate level of support that individuals require. Staff spoken with were fully conversant with the needs of those living at the home, including changing and future anticipated needs and support requirements. Staff were respectful when talking about individuals and information given cross-referenced within information seen in care records or what the inspector had been told by residents. It was evident that the home has established professional relationships with others such as; GP’s, district nursing staff, care managers and members of the Community Learning Disabilities Team in order to work together to ensure that the needs of those living at The Redhouse are identified and met. The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 22 There is currently an individual at the home who has a high level of need in all areas of their personal care, they require assistance with meals, and assistance with all transfers and also requires support with their continence management. At the time of the inspection there was only one staff member on duty, it was confirmed by staff that only one member of staff is on duty between the hours of ten and three, with one staff member on duty throughout the night sleeping on the premises. The care plan for this individual identified that two staff members are required with certain aspects of the individuals care. The current staffing levels in place are not sufficient. Correspondence was seen from the registered manager to a team manager confirming that due to the high level of care and attention one individual needed there had been occasions where this had impacted on the service provided to others living at the home, examples seen were that individuals had missed healthcare appointments and social events. A staff member also confirmed that this had been the case. It is required that a review of the staffing arrangements must be undertaken to ensure that the needs of all are being met, this was an immediate requirement and will be reviewed by the inspector within seven days. Although training records were not available for inspection staff members spoken with said that since the last inspection they had undertaken training in the protection of vulnerable adults and fire safety. Another staff member confirmed they are continuing with undertaking their national vocational qualification at level three in promoting independence. The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38, 40, 41, 42 The management of the home is not stable at this current time with some concerns raised over fire safety within the home. EVIDENCE: Since the last inspection there is a new registered provider Mr Errol Moodie, Mr Moodie knows all of the residents living at the home as he has been a ‘silent’ partner of the business for over twenty years and is recognised by the residents. Mr Moodie underwent his ‘fit’ persons interview on 28 June 2005. A condition of this appointment was that Mr Moodie must undertake Protection of Vulnerable adults training, this has not happened and therefore a requirement was made at this inspection that this training must be undertaken. A requirement was made at the previous inspection that visits made by the registered provider must be undertaken on a monthly basis and these must be forwarded to the Commission. This has not been done. These visits are essential to monitor service provision and quality and cover areas such as health and safety, staffing and monitoring of care delivery. This requirement will remain and will be reviewed again at the next inspection. The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 24 Also, since the last inspection, the deputy manager has left, and has not yet been replaced and the current registered manager is currently working out their notice. Mr Moodie has informed the commission that a new manager has been appointed and it is anticipated that they will be in post before Christmas, this person will be subject to the ‘fit’ persons process. The inspector viewed the organisational policies and procedures in place at the home, these are robust and provide sufficient information in order to direct and guide staff practice. The policies seen were appropriate to the service provided at the home. It was noted that there are no guidelines in place in order to outline to staff what their responsibilities are when working alone. As this occurs on a regular basis at the home during both the day and night it is required that a lone working policy be developed to ensure consistency of practice. An examination of the fire logbook showed that a number of areas require attention to ensure the safety of those who live and work at the home. Weekly fire alarm testing must be completed on a consistent basis this had been intermittent. Emergency lighting must be checked on a monthly basis, this was a requirement made at the last inspection and again this was found not to have been met. There was no evidence to show that new staff had received fire instruction and other staff had not received sufficient instruction Staff must receive sufficient fire instruction to ensure that they are competent and fully conversant with the procedure. The home has in place a fire risk assessment however it is recommended that this risk assessment includes what the procedure is at night. The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 3 x Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 2 2 X 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 2 X 3 x CONDUCT AND MANAGEMENT OF THE HOME x Standard No 37 38 39 40 41 42 43 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Redhouse Residential Carehome Score 3 3 3 x X 3 X 2 3 1 x DS0000065123.V261865.R01.S.doc Version 5.0 Page 26 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA33 Regulation 18(1) Requirement A review of the staffing arrangements must be undertaken to ensure that the needs of all are being met. Care plans must be reviewed on a regular basis. A review of security within the home must be undertaken. Monies held on behalf of residents must be stored in a lockable facility. The poor television reception in a resident’s room to be addressed. Residents must be consulted as to whether they would like to be able to lock their own rooms. A lone working policy to be developed. The home’s adult protection policy to be updated. Weekly fire alarm testing must be completed Staff must receive sufficient fire instruction. Medication records must be fully completed. Visits made by the registered provider must be undertaken on a monthly basis and these must be forwarded to the Commission. DS0000065123.V261865.R01.S.doc Timescale for action 22/11/05 2 3 4 5 6 7 8 9 10 11 12 YA6 YA23 YA23 YA26 YA26 YA40 YA23 YA42 YA42 YA20 YA43 15 23 13 16 16 18 13(6) 23(4) 23(4) 13(3) 26 22/12/05 22/12/05 22/12/05 22/12/05 22/12/05 22/02/06 22/01/06 22/12/05 22/12/05 22/11/05 22/01/06 The Redhouse Residential Carehome Version 5.0 Page 27 13 14 YA23 YA42 10(3) 23(4) The registered provider must undertake protection of Vulnerable Adults training. Emergency lighting must be checked on a monthly basis. 22/03/06 22/11/05 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 Refer to Standard YA1 YA6 YA42 Good Practice Recommendations The Statement of purpose to be updated to include the current management status of the home. Consideration to be given to the use of language and terminology used within residents records. The home’s fire risk assessment to include what the procedure is at night. The Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 28 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Redhouse Residential Carehome DS0000065123.V261865.R01.S.doc Version 5.0 Page 29 - 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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