Inspection on 05/10/07 for The Red House Residential Carehome

This inspection was carried out on 5th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 no outstanding requirements from the previous inspection report, but made 7 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... 17/10/06

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

The Red House Residential... 22/11/05

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 Red House Residential Carehome 5 Conygre Road Filton South Glos BS34 7DA Lead Inspector Odette Coveney Unannounced Inspection 5th October 2007 09:30 The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Red House Residential Carehome Address 5 Conygre Road Filton South Glos BS34 7DA 0117 969 3053 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) theredhouseresidentialhome@yahoo.com Mr Heron Moodie Mr Royston John Orme Care Home 10 Category(ies) of Learning disability (10) registration, with number of places The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home providing personal care only- Code PC To service users of either gender whose primary care needs on admission to the home are within the following category: 2. Learning disability- Code LD The maximum number of service users who can be accommodated is 10. 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 range of fees start from £518.00 per week up to £627.00. The home is located in the South Gloucestershire region in the residential area of Filton. The home was successful in applying for a major variation in order to increase the home’s numbers from 8 to 10 to accommodate two residents in the house next door, these individuals have not moved in yet. It is anticipated that they will be moving into the adjacent house within the next two weeks. The Red House 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 building 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 Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 5 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 Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key standard inspection and was carried out in three visits to the service, the first visit was undertaken on 5th October 2007 and took 7 hours with two inspectors, a further visit by one inspector was completed on 12th October and two inspectors returned to the home during the evening of 16th October in order to spend time with residents and talk with them about their life at the home. These site visits were comprehensive and a judgement of poor was made. It must be acknowledged that the home has worked diligently to meet the previous requirements made at the last site visit to the home and many positive steps have been made to improve the quality of life for individuals who live at the home. An opportunity was taken to view the home and a number of the records relating to the management of the home and plans of care for three Individuals were reviewed. The registration certificate for the home was reviewed at this inspection and the information contained within it was found to be accurate. What the service does well: The homes care review and monitoring processes will ensure that each individual receives the care they need. Residents are able to participate in a range of meaningful activities and spend their time as they wish. They are provided with well balanced and nutritious meals. Residents can be assured that any complaints they have will be dealt with and that they will be safeguarded from any harm. Residents are cared for in a home that is comfortable and homely, clean and tidy. The bedrooms are all for single occupation and each room has it own wash hand basin. The residents are cared for as “individuals” and the staff team are knowledgeable about each person’s likes and dislikes and good relationships between staff and residents on the whole, have been established. The home is generally well managed and run in the best interests of the residents. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: In order that prospective residents, their carers and commissioners of services are fully aware of the services and facilities provided at the home it is required that the home review and update their statement of purpose. In order that there is no confusion the home must ensure that contracts contain clear and full information in respect of the fees charged by the home. In order that clear information is in place to support residents with their manual handling and pressure care needs it is required that these assessments contain specific detail in order that they are clear for the person using the information. Resident’s files would benefit from being put in order. Systems of medication administration and recording must be improved to protect residents from harm and to ensure that systems in place are robust and provide clear instruction for staff. In order to ensure the protection and safety of both residents and staff, clarity and definition should be given to the term ‘reasonable force’ in the home’s restraint policy. Furthermore it is recommended that receipts for resident’s purchases be numbered, making it easier for auditing purposes. Intimate care policies should be explored and developed with individuals in order that they are given personal support in the way they choose. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 8 Care plans must fully reflect that individuals have been consulted about their religious, cultural and dietary needs with evidence provided to demonstrate that these areas have been fully explored with individuals In order that individual’s wishes and choices in respect of their death is respected this information should be obtained and recorded. Individuals must be treated with dignity and respect by staff at all times, staff should be reminded of their role and responsibility in this area. In order to demonstrate that checks are undertaken at appropriate intervals it is required that the electrical lighting test certificate should be dated for validity Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 9 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 Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5. The quality outcome in this area was adequate. This judgement has been made using available evidence including a visit to this service. The statement of purpose and the terms of conditions of the placement requiring reviewing in order that they contain clear accurate information. Individuals are well supported in the admission into the home and can be confident their needs will be met. EVIDENCE: There are two statements of purpose and a service users guide, one for The Red House and one for Bellevue Cottage. Both documents are comprehensive and provide information about the admission process, a description of the home and its facilities and some background information about the history of the home. There is also information about the staffing arrangements and management structure of the home. These documents have been enhanced since the last visit to the home due to the use of photographs. It was noted that the Statement of Purpose for the Red House did not have sufficient information to inform individuals about the range of diverse needs in respect of equalities and diversity of individuals and how they would be supported to maintain their culture if that is their wish. Also document did not have the correct name or address of the Commission. In order that prospective residents, their carers and commissioners of services are fully aware of the services and facilities provided at the home it is required that the home review and update their statement of purpose. Once this has been updated a copy of this must be forwarded to the Commission. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 11 The care records of the most recently admitted individual into the home were reviewed and it was found that this individual had their needs assessed by a care manager and also by the manager of the home. Care assessments, daily records and admission documents evidenced that the individual had been consulted and their wishes and choices recorded and incorporated into their care plan and risk assessments. Prior to the site visit the Commission was contacted by a relative of an individual who lives at the home, they had recently been issued with the annual contract. During this site visit contracts for individuals were reviewed and it was found that these provided information about the terms and conditions of the placement, information about the categories of registration and the services to be provided and what is included within the fees. Contracts were found to be confusing in respect of fees payable and by whom. It is required that these contracts must be reviewed in order that they contain clear and full information in respect of the fees charged by the home. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individualised planned care is well documented in terms of health, communication, emotional and physical care needs, further information is needed to ensure individuals cultural and dietary needs have been explored. Staff have a good awareness of individuals’ needs. EVIDENCE: Three residents had their care plan reviewed as part of this visit. Each of these residents had a plan of care, which had been developed from a comprehensive assessment of their care needs. The care plans set out the actions needed by care staff to ensure all aspects of the individual’s emotional, social, health and personal care are addressed. Care plans showed that they are encouraged and supported to make decisions and choices about areas, which affect their lives. Residents personal preferences and choices have been recorded. This included how they wanted to be addressed their likes and dislikes for food and the sort of activities they enjoyed. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 13 It was noted that a care plan completed by the Community Care department prior to admission into the home recorded an individuals allergies to certain foods, however, the care plan completed by the home did not contain any of this essential information and the potential to danger had not been transferred. Furthermore it was required that individuals care plans must fully reflect that individuals have been consulted about their religious, cultural and dietary needs with evidence provided to demonstrate that these area have been fully explored with individuals with evidence to show that all potential avenues have been explored. There are both male and female residents at the home along with male and female staff. It is required that intimate care policies are implemented in order that individuals have been consulted and given choices about how they are supported with their personal care. The care planning included risk assessments for manual handling and risk of falls. Where a risk had been identified the care plan guided staff how to reduce the risk of falls for the individual resident. It was noted that the manual handling assessments were not clear and the information could prove confusing for the reader, these assessments must be reviewed in order that appropriate guidance in place records how individuals would be supported once a risk has been identified. Each of the plans of care reviewed had been reviewed monthly or sooner if the residents care needs had changed. The home has been transferring ‘loose leaf’ records into a ring binder file, it is recommended that all resident’s files would benefit from being put in order. During the last site visit to the service a requirement was made that risk assessments in respect of resident’s activities were to be reviewed and updated where required a review of this documentation found that this had been undertaken. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individuals at the home are well supported to participate in activities of their choice; all staff members do not treat individuals with respect. Responsibilities and risks are recognised in individual’s daily life. EVIDENCE: Mr Roy Orme had a clear understanding of his role and responsibility within the home and was able to demonstrate understanding of the needs of the residents. Mr Orme accesses copies of care/management publications and attends specific conferences in these areas in order to keep his knowledge up to date and in line with current good practice. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 15 The manager and staff support residents to become part of, and participate in the local community in accordance with assessed needs and individual plans. Staff enable individuals integration into community life through knowledge and support to enable individual’s to make use of services, facilities and activities in the local community, such as shops, church, pubs, college and cinema. Information seen by the inspector, confirmed by staff and seen on individual’s records showed that those living at the home are offered a variety of social, leisure and educational activities. Individuals are able to participate or not, this is dependent on the individual’s choice. Information seen in daily records evidenced that individuals regularly are supported to visit places of local interest and local community groups. On the day of the site visit individuals were at local resource and activity centres, one individual was being supported to go shopping to purchase clothes and another resident was relaxing at home. A resident told how they have been recently supported by staff to access a local college and are enjoying attending a history course and meeting up with friends there. During an evening visit to the home two staff members were observed talking about residents in their presence with no regard to their feelings or their being an adult. This was discussed with the manager and it is required that individuals must be treated with dignity and respect at all times and staff should be reminded of their role and responsibility. The home has an open visiting policy and visitors can come in at any reasonable time. Discussions with the manager evidenced that the home has very good relationships with the families of the residents. It was clear from information seen in records, discussion with residents and the manager that individuals are supported with their relationships on both an emotional and practical level. The kitchen was found to be clean and tidy with clear menu planning processes in place. Residents are able to be involved in menu planning and are supported to shop and prepare meals. The menu was seen to be well-balanced incorporating fresh fruit and vegetables with good quality foods being used. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Individuals are supported appropriately in aspects of their personal, physical, emotional and healthcare needs and these are well met. Systems of medication recording and administration are dangerous and improvements must be made in this area. EVIDENCE: The care plans viewed demonstrated how the residents had access to health and psychological services to meet their assessed needs. One resident whose care was followed had a record of the other healthcare professionals who had seen them. The health professionals included the crisis intervention team care management professionals and health care staff have made recommendations about the way health care should be delivered and the care plan had been changed to include this advice. The care planning documentation included psychological health care monitoring. Where this had been identified as an issue for one resident; a plan of care guided staff how to care for this resident’s psychological needs and how to support others living at the home and keep themselves safe. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 17 Residents had an identified GP who provided their medical care. When a resident had seen their GP this was recorded in their plan of care. Any change in treatment requested by their GP had been incorporated into the plan of care. Pressure care assessments were in place, however, as per the manual handling assessments, the information was not clear and could prove confusing for the reader, it is required that these assessments are reviewed to ensure that the information recorded has been completed fully, All, but one resident who take medication at The Red House are supported with this by staff. A staff member showed the inspector the medication administration systems in place at the home. The staff member appeared conversant with her role and responsibility in this area and the importance of adhering to policies and procedures that are in place for the safe administration of medication. However a review during the visit revealed a number of errors. The medication was appropriately stored and was well organised. But medication records were not up to date and in order. Systems of medication administration and recording must be improved to protect residents from harm and to further ensure that systems in place are robust and provide clear instruction for staff. The following must be undertaken; • • • • • Controlled Medication must be recorded and accounted for. Recording systems for medication given must be improved. Records must be in place to account for stock held medication. A disposal of medication record must be in place at the home. Creams prescribed for resident’s use must be clearly labelled. It is further recommended that the home obtains an up to date medicines information book. All staff handling medication have attended training with the manger confirming that refresher training is being provided to staff by the pharmacist who supplies medicines to the home. A review of resident’s records found that not all individuals had recorded their wishes in the event of their death, it is acknowledged that this is a difficult subject, however it is recommended that this information is sought and recorded in order that wishes and preferences are recorded. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are clear processes in place in which individuals can raise concerns; individuals are protected from abuse. EVIDENCE: The residents were seen expressing their concerns and wishes freely to the staff that were caring for them. The complaints policy and procedure was easily available in the reception area of the home. The manager advised that he operates an open door policy, which enables relatives, residents and staff to speak to him if they have any concerns. The home’s complaints procedure is included in the homes statement of purpose and displayed in the main reception area. Residents spoken with during the course of the visit said they would talk to the staff if they were not happy about anything. The home has not received any complaints and prides itself on having good relations with not only the residents, but their families too. One resident said, “There is nothing to complain about at all” whilst another said, “the staff are good”. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 19 The home has policies and procedures in place to ensure that the residents are safeguarded from any form of abuse. Staff have attended adult abuse awareness training delivered by South Gloucestershire Council. A copy of the home’s policy about the protection of vulnerable adults (POVA) is kept with all other policies and procedures and the day-to-day paperwork. Staff spoken with during the visit demonstrated a good awareness of adult abuse issues and of their responsibility in reporting any bad practice. There has been a recent occasion, due to the complex needs of an individual at The Red House, where physical aggression has been displayed. Records seen such as behavioural guidelines, notification of incidences forms and incident reports demonstrated that these behaviours are understood by staff and are dealt with appropriately. Staff have been booked to undertake in October nonviolent physical intervention training. The home has a restraint policy and this is very comprehensive, however clarity and definition should be given to the term ‘reasonable force’ in the home’s restraint policy. Following a review of residents records of money a recommendation was made during the last site visit to the home that the manager should develop a system to demonstrate that individual’s bank account transactions are being monitored, it was seen that the manger signs bank statements to demonstrate that these have been crossed checked with balances held. A sample of residents monies held were checked against money held at the home for safekeeping and all tallied with records held, however, it is recommended that receipts for resident’s purchases be numbered, making it easier for auditing purposes. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 28, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents have a well maintained pleasantly decorated home to live in, which continues meets their changing needs. EVIDENCE: The Red House is registered with the Commission to provide a service for up to 8 persons aged 19 – 64 years, currently there are no vacancies at the home. Living at the home are three men and five females. The Red House is a large detached building. The registered providers also own a cottage which is next door to the home, there is one individual who lives in this house who is supported by staff to maintain their independence. The home is located in Filton and is just a short walk from local shops, Filton College, a bank, church and public houses. The home is approached via a driveway and a path from the main road and there is level access into the home. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 21 The gardens to both the front and rear of the property are well kept and accessible to residents. The communal areas are all located on the ground floor, along with two of the bedrooms and one of the assisted bathrooms. There is a spacious lounge, and the dining room is located next to the kitchen. There is no lift in this home and therefore residents need to be fairly mobile. The furniture and fittings throughout The Red House are comfortable are domestic in style and are appropriate to meet the needs of the residents. The residents were observed using all communal areas and accessing freely their private rooms. All bedrooms are for single occupation and have facilities of at least a wash hand basin. Residents are encouraged to personalise their own rooms and to bring in any items of furniture they wish. One resident said, “ I have a wonderful room”. Each bedroom is fitted with a door lock and the residents can have a key if they wish. The bedroom furniture is varied throughout the home. Each bedroom has a window and the degree of opening has been limited on each, to safe guard residents. All radiators throughout the home are guarded with boxed radiator covers. The home has in place a system for staff to follow should they need to inform management of any ‘health and safety issues’ such as repairs, maintenance or equipment that requires attention. The home was clean, tidy and well maintained and there were no odours throughout. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 34, 35. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A competent, well-trained caring staff team provide care for the residents in a way that promotes their individuality. EVIDENCE: The manager operates a robust recruitment policy, which protects the residents from unsuitable staff. Each of the staff files viewed during the inspection had two references on file. The manager confirmed that no staff are employed in the home until they have a satisfactory police check returned. All the staff files seen had evidence of a police check being obtained prior to the staff member starting work. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 23 The home ensures that all staff receive relevant training that is focussed on delivering improved outcomes for those using the service. The home puts a high level of importance on training and staff confirmed that they are supported through training to meet the individual needs of those living at the home; staff training records and certificates seen evidenced that staff have completed core training in areas such as first aid, protection of vulnerable adults training and basic food hygiene, other specialised training is also provided for staff in areas such as, medication competency and non crisis intervention. A requirement was made during the last site visit to the home that staff must receive training in epilepsy awareness, this was in order to support residents and have an understanding of the condition, both the manager and staff members confirmed that this training had been undertaken. Staff can have access to the home’s written grievance and disciplinary procedures. There are also procedures in place for dealing with physical aggression towards staff. The inspector spoke individually with a staff member who said they are very happy within their role at the home and said that they felt well supported both by the management and the organisation, this member of staff knew who to speak with if they were unhappy. This member of staff was fully conversant with the in depth and complex nature of the support that individuals require at the home and gave sound examples of how individuals are given choices and how their rights are promoted and how individuals are treated as adults. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home benefits from good leadership and management, its practices have offered protection to the health and safety of residents. The home is run in the best interests of the residents. The home ensures that individual’s interests and rights are promoted and protected by a knowledgeable staff team. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 25 EVIDENCE: The registered provider Mr Heron Moodie makes strenuous efforts to ensure care is provided to the highest standard. Previous inspection history indicates the provider takes action as necessary to comply with the Care Homes Regulations and National Minimum Standards. In order that the registered provider is aware of his responsibilities in respect of adult protection a requirement was made during the last site visit that Mr Moodie must undertake protection of vulnerable adults training, confirmation was provided during this visit and by Mr Moodie that this training had been undertaken, Mr Moodie said that this training had been interesting and provided useful information. Mr Orme has been employed in the role of manager at the Red House since December 2005. His previous experience in the care industry began in 2002. He has the following qualifications relevant to the registered manager position: NVQ Level 2, Food Hygiene, Health and Safety, First Aid, Learning Disabilities Awareness and Administration. At this site visit Mr Orme confirmed that he has completed his National Vocation Qualification in Care management at level 4. Throughout the visit Mr Orme conveyed a commitment to providing care that met the needs of the service users, and promoted and protected their health and well being. The development of the staff team, with appropriate training, would provide the foundation for the provision of individualised care packages at the Red House. The manager has a very “hands-on” approach and is very involved with the day-to-day care of the residents and working alongside the staff team. Staff meetings and residents meetings are held on a regular basis and there was evidence that everyone is encouraged to make suggestions about how the home is run and what happens. There was evidence that the manager and his team were committed to maintaining good levels of service at The Red House and also to improving services. At the last site visit it was found that emergency lighting was not being checked for effectiveness on a regular basis and therefore a requirement was made that these must be checked on a consistent basis. During a review of the fire logbook which recorded these checks, it was found that this requirement had been met, however a check for lighting was not clear and it was recommended the electrical lighting test certificate should be dated for validity. There was evidence that the home ensures so far as is reasonably practicable. the health and safety of residents, staff and visitors. The home has robust policies and procedures in relation to aspects of health and safety. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 26 The inspector viewed the fire logbook for the home. The home was completing the appropriate checks on the fire equipment and the recording of training, fire drills and the testing of equipment were satisfactory. The fire panel was seen to be in working order. A review of the fire logbook found that staff are receiving sufficent fire instruction and drills, maintence and equipment checks are undertaken on a regualr basis. The home has in place a fully comprehensive fire risk assessment; this covers the identification of hazards and actions taken to eliminate/reduce risk. This assessment must be dated and demonstrate that this is regularly reviewed. Staff supervision was reviewed. Evidence from the records viewed showed that staff have received supervision. Staff spoken with confirmed that they have received supervision and that they benefited from the exercise. The home displays a current certificate of Employer’s Liability Insurance. The home has in place clear policies and procedures in areas of staff employment, individual’s finances and health and safety, all of which have been reviewed and updated. This guidance provides clear information to staff to inform and guide their practice. Staff spoken with confirmed that they felt supported and able to approach the manager and the registered providers should they wish to discuss day-to-day running of the home. One staff member said ‘I enjoy my job here, I am very happy’. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 27 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 Standard No Score 1 2 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 1 3 3 3 3 X X 3 X The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 28 No 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. 2. Standard YA1 YA9 Regulation 4 (1) 13 (5) Requirement The home must review and amend the statement of purpose for The Red House. Manual Handling assessments must include how individuals will be supported once a risk has been identified. Pressure care assessments must contain clear information in order to support individuals appropriately. Care plans must fully explore and incorporate all of individuals needs in respect of cultural, religious and dietary requirements. Contracts between the home and residents must contain clear information about the fees charged. Intimate care policies to be developed. Systems of medication administration and recording must be improved. The following must be undertaken; • Controlled Medication must be recorded and accounted for. • Recording systems for DS0000065123.V352724.R01.S.doc Timescale for action 05/12/07 05/12/07 3. YA19 17 (1) a 05/12/07 4. YA6 15 (1) 05/12/07 5. YA5 5 (1) b 05/12/07 6. 7. YA6 YA20 12 (2) 13(2) 05/01/08 05/10/07 The Red House Residential Carehome Version 5.2 Page 29 • • • medication given must be improved. Records must be in place to account for stock held medication. A disposal of medication record must be in place at the home. Creams prescribed for resident’s use must be clearly labelled. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard YA21 YA6 YA23 YA23 YA42 YA20 Good Practice Recommendations The home must seek and record the wishes of individuals in the event of their death. Resident’s files would benefit from being put in order. Clarity and definition should be given to the term ‘reasonable force’ in the homes restraint policy. Receipts for residents’ purchases held for safekeeping should be numbered. The electrical lighting test certificate should be dated for validity. The home should obtain an up to date medicines information book. The Red House Residential Carehome DS0000065123.V352724.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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