Care Home: Red Roofs Care Home

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What the care home does well Anyone new wanting to come to the home is assessed beforehand to identify what the person`s needs are and if the home is able to meet them. This information is then shared with staff so they know what they are expected to do. One person told us "Someone from Social Services came to see me. The matron also came to see me and told me about Red Roofs. They asked me what I could do for myself. " People have their healthcare needs met and are able to have medical support when they need it. One person said, "I was at hospital yesterday to see an eye surgeon. My doctor has been to see me here, I can`t expect anymore." People are treated with respect and dignity. One person told us, "They bath me every Friday morning, I can ask for another if I want. Its always very private." An activities coordinator is employed who oganises group activities and arranges for entertainers to come to the home. A resident said, "I can`t join in a lot but there is something on most days. There is a list on the door." Visitors are welcome to come and see their friends and relatives in the home, and regular church services are held in the home. People are able to make choices about their daily routines and a resident told us, "I am always up at 6 o`clock, I get myself up, I have lots to do, and I put myself to bed when I am ready." People are given information about how to complain if they are not happy about anything. One person said, "I go to the office and leave a note on the desk if someone is not there, then they get in touch with me". Staff know how to protect people in the event of any allegation and people told us they feel safe in the home. The home is kept clean and homely, and there are suitable arrangements for the disposal of waste products. One person said, "Everywhere is kept in good condition and there are lovely views, you can see Belvoir Castle on clear days." There are sufficient and suitably trained staff on duty who have been through the required recruitment checks. One person told us, "If I press the call bell someone will be here in couple of ticks." Some staff have a professional qualification and other staff are working towards one. Staff receive regular training and new staff undergo an induction once they have completed the pre employment checks. There is a suitably qualified and experienced manager in post, and people are encouraged to comment on how the home is run. The required health and safety checks and tests to the building and equipment are carried out. What has improved since the last inspection? There were not any requirements or recommendations set at the last inspection. What the care home could do better: Care plans would be improved through including greater detail of how people`s needs are to be met, they should assess people`s mental capacity and recognise any deprivation of liberty taking place. One person commented, `They take care of all our needs, medical and social.` Anyone who wishes to be responsible for managing their own medication must be assessed before they do so to ensure they are able to do this safely. The majority of people were happy with the food provided, although residents would have greater opportunities to make choices and have meals they enjoy if there was a choice of meal provided on the menu. One person said, "It would be nice if we were able to have a choice." Key inspection report Care homes for older people Name: Address: Red Roofs Care Home 35a Grange Road Newark Nottinghamshire NG24 4LH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Stephen Benson     Date: 0 9 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Red Roofs Care Home 35a Grange Road Newark Nottinghamshire NG24 4LH 01636707298 01636678423 rgd@redhomes.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Margaret Jean Daniel care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The home is purpose built and is within a couple of miles of the centre of Newark. There is a good level of adaptation to meet the needs of people with a physical disability. The furnishings and lighting in communal areas are domestic in character. People are encouraged to bring in items of furniture from home to personalise their rooms. There are ample communal, bathing facilities and areas for social recreation. The grounds are tidy, secure and accessible to wheelchair users. The fees for this service range between £406.00 per week £468.00 to per week. 0 Over 65 30 Care Homes for Older People Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Care Quality Commission is upon outcomes for people accommodated and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This was our first visit to the home since 1st April 2009. This inspection involved one inspector; it was unannounced and took place in the daytime, including lunchtime. Prior to the visit an analysis of the home was undertaken from information gathered over the last year including that from the Annual Quality Assurance Assessment they completed. We sent survey forms entitled Have your say about... to a sample of 10 service users and all of these were returned. The main method of inspection used is called case tracking which involved looking at the quality of the care received by a number of people living at the home. We also Care Homes for Older People Page 5 of 26 used evidence from our observations; we spoke with them about their experience of living at the home; we looked at records and talked with staff about their understanding of the peoples needs who they support. The premises were not inspected in detail but various areas of the home were visited as part of the inspection. Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 7 of 26 Care plans would be improved through including greater detail of how peoples needs are to be met, they should assess peoples mental capacity and recognise any deprivation of liberty taking place. One person commented, They take care of all our needs, medical and social. Anyone who wishes to be responsible for managing their own medication must be assessed before they do so to ensure they are able to do this safely. The majority of people were happy with the food provided, although residents would have greater opportunities to make choices and have meals they enjoy if there was a choice of meal provided on the menu. One person said, It would be nice if we were able to have a choice. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People coming to the home will know their needs can be met, as they have been assessed. Evidence: The care files for two recently admitted residents were seen and these both contained assessments that were completed prior to the person moving into the home. A senior member of staff said that either the provider or herself will go and do an assessment, or alternatively this can be done in the home if they come to visit before hand. Staff said they were told about the needs of the most recently admitted resident during a handover, and that they are able to read the care plans which have the required information, including the assessment. Care Homes for Older People Page 10 of 26 Evidence: In our survey forms everyone said they had received enough information prior to moving into the home and a resident told us, Someone from Social Services came to see me. The matron also came to see me and told me about Red Roofs. They asked me what I could do for myself. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health, personal and social needs are being met in a dignified manner, but the care they require is not always clear in their care plans. Evidence: A sample of three care files were seen. One care file for a recently admitted resident did not have any care plans prepared yet. The other files included care plans which were regularly reviewed and showed that residents and/or relatives are at least sometimes involved in preparing and reviewing care plans. However the care plans seen did not include all the detail required, including no reference to peoples mental capacity or where there was a deprivation of their liberty. A senior member of staff said that the current care plans are outdated and they are currently preparing to move to person centred plans, which will include information about peoples mental capacity. Staff were aware of how to use care plans and ensuring they are kept up to date. They have started receiving training on the new style of care planning going to be Care Homes for Older People Page 12 of 26 Evidence: used in the future. In our survey forms everyone said they always or usually receive the care and support they need and staff act upon what they say. A resident commented, They take care of all our needs, medical and social. A resident told us, I think they have it (care plan) in the office, they completed some papers with me then took them away. One care file seen showed a resident had fallen on several occasions in her bedroom and a referral had been made to the Occupational Therapist, who provides guidance when people are at risk of falls. It was noted that there had been falls over several months, and an earlier referral could have been made. The care files showed that peoples health is monitored and staff knew how to respond if someone was unwell. In our survey forms everyone said they always receive the medical support they need. A resident told us, I was at hospital yesterday to see an eye surgeon. My doctor has been to see me here, I cant expect anymore. The storage and arrangements for recording controlled drugs did not comply with the current required practices. Following the inspection it was confirmed that a controlled drugs register is now in use and a cabinet for storing controlled drugs in has been ordered. There were some residents who self medicate their own creams and inhalers, however there were not any self medication assessments completed. Staff who administer medication said they have been trained for this and knew to always observe someone taking their medication. One person told us, I take a lot, inhalers, eye drops as well, they give them to me at mealtimes as I am supposed to have them. A senior member of staff is the dignity champion and staff said she actively promotes peoples privacy and dignity. One person commented on our survey forms, They look after residents with dignity. A resident told us, They bath me every Friday morning, I can ask for another if I Care Homes for Older People Page 13 of 26 Evidence: want. Its always very private. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have opportunities to take part in activities both in and out of the home. There are opportunities for people to exercise choice in their lives, and they are provided with a wholesome diet. Evidence: There is an activities coordinator who comes to the home twice a week and entertainers are booked to come twice a month. Details of forthcoming activities and entertainers are displayed on notices around the home. One resident was seen playing the piano during the morning. In our survey forms everyone said there are always activities arranged they can take part in. One person told us, I cant join in a lot but there is something on most days. There is a list on the door. Trips out of the home are arranged during good weather, including regular boat trips. A monthly church service is held in the home. Residents confirmed that visitors are welcome at any time. Care Homes for Older People Page 15 of 26 Evidence: Staff spoke of promoting choice for people including every day matters such as bathing arrangements and said they encourage people to be as independent as possible. One resident told us, I am always up at 6 oclock, I get myself up, I have lots to do, and I put myself to bed when I am ready. There is a varied 4 week menu which currently does not provide a choice of meal at lunchtime. The cook said she had recently prepared a lasagne, which was well received by some of the residents. Staff said that an alternative is provided if requested, some people prefer to have a bowl of soup. In our survey forms three people said they always like the food in the home, six said they usually do and one said they sometimes do. One person commented The food is very good and another resident told us, It would be nice if we were able to have a choice. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People will raise any complaints they have knowing they will be investigated. People feel safe in the home. Evidence: The complaints procedure has recently been updated to reflect recent changes, and there is a book to record any complaints in. There were three recent complaints recorded, one of which was that the new procedure was too small to read. This was reproduced in a larger font, making it easier to read. The other complaints concerned clothing matters and were satisfactorily resolved. In our survey forms everyone knew how to make a complaint, and one person told us, I go to the office and leave a note on the desk if someone is not there, then they get in touch with me. Staff are due to attend a training course later in the month and are currently working through a safeguarding booklet. Staff were aware of the procedures to follow and knew about the homes whistleblowing policy. A resident said when asked if he felt safe in the home, Yes, safer than in the last place I was in. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable and well maintained environment that provides a homely atmosphere. Evidence: Areas of the home seen were well decorated and maintained, providing a homely feel. The senior staff said they regularly receive comments on how lovely the home looks. Staff said any maintenance is promptly attended to, and the layout of the building is suitable for the tasks they have to carry out in the course of their duties. In our survey forms everyone said the home is fresh and clean. One person told us, Everywhere is kept in good condition and there are lovely views, you can see Belvoir Castle on clear days. There are supplies of protective clothing available and staff said they use these when providing any personal care. There is a carpet cleaner to keep carpets clean and fresh. Care Homes for Older People Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared and supported by sufficient staff who have been suitably trained to meet their needs. Evidence: Some of the staff have worked in the home for a number of years, which the senior member of staff said helps make a settled staff group. An additional carer has been added to work during the busier times in the evening, when it was felt this was needed. Staff said they felt there were enough people on duty to meet the needs of the residents and in our survey forms everyone said staff were available when they needed them. One person said, If I press the call bell someone will be here in couple of ticks. All of the care staff have either got a professional qualification or are working towards one. Some staff have gone on to achieve a higher level qualification. The file for the most recently appointed member of staff was seen, and this contained the required pre employment checks. The member of staff said she had completed an application form, provided two referees and undergone a Criminal Records Bureau check (CRB). The member of staff said she was working through an induction and the Care Homes for Older People Page 19 of 26 Evidence: senior member of staff said they use the Skills for Care Common Induction Standards. Staff training records showed that regular training is provided and there is a plan for future training. Staff were aware of what training they are due to attend and what training they are expected to have completed. A resident told us, When there are new staff they get shown what to do till they get used to it, so they can do everything properly. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable management arrangements in the home to ensure the home is run in the best interests of people living there. Evidence: The registered manager, who is also the registered provider, shares the running of the home with a group of senior staff. Staff said that they thought the management arrangements of the home are very efficient. There is a system in place for seeking the views of people who use the service and action is taken on any points raised. There are also residents forums meetings and the most recent minutes showed discussions took place about fire safety, the homes shop and planning for Christmas. There is a system to help people manage their personal allowances, and one of the Care Homes for Older People Page 21 of 26 Evidence: people case tracked makes use of this service. The records were checked and found to be correct. The senior member of staff said that equipment is serviced or tested as recommended by the manufacturer or other regulatory body and they do not have any health and safety concerns. A resident said, I hear the fire alarm being tested. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 26 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 Care plans must be more 01/03/2010 detailed and there must be a process in place to assess peoples mental capacity and recognise any deprivation of liberty taking place. This will promote people to retain as much control of their lives as they can. 2 9 13 People who are responsible for taking their own medication must be fully assessed as being competent to do so. This will ensure people who take responsibility for their own medication are able to do so. 01/01/2010 Care Homes for Older People Page 24 of 26 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 15 Provide a choice of main meal at lunchtime. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2009) Care Quality Commission (CQC). 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. 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