Care Home: Redbrick Court Care Centre

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What the care home does well The service provides people with detailed information about what it has to offer. Each person needs are assessed before a place is agreed to ensure the service is able to meet these. A person-centred approach to assessing needs continues to be developed and implemented. People live in a comfortable and homely environment. They feel any issues or concerns they raise are looked into and addressed, wherever possible. The service is run by an experienced and suitably qualified person who has been registered by us, the Commission for Social Care Inspection (CSCI). The staff team is provided with good information and training opportunities to ensure they are able to meet people`s needs and personal preferences. There are good in-house and company systems for monitoring the service`s performance. This includes seeking the views of people living at the home, their relatives and other stakeholders. What has improved since the last inspection? The requirements made at the previous inspection have been addressed. The service continues to improve the environment for the people who live here and it has made suitable arrangements to reduce the risk of infection within the home. A person-centred approach to care planning is being implemented. This involves better consultation with individuals about needs, personal preferences and interests. Where appropriate, this includes discussions with her/his relatives. Regular discussions are held with people about menu planning and the service provides a choice of meals that meets the individual`s dietary needs and personal preferences. A regular supervision programme has been implemented to support staff to carry out their duties. An annual appraisal is undertaken to discuss the individual staff member`s performance and identify her/his training needs. A training programme has been produced for all staff and includes abuse awareness to ensure people are protected from harm. The training for caring for people with dementia and dignity in care has led to a more confident delivery of service to the people who live here. What the care home could do better: The service needs to improved arrangements to ensure the areas identified in this report remain free from malodours at all times. A programme of work should be identified and implemented for the re-decoration and refurbishment of the kitchen. In general the service has good systems for the handling and administration of medication. However, detailed protocols should be kept accessible to staff for administering "as required" medication prescribed to calm or sedate. This is to ensure a consistent approach is followed. Recordings of the decision made to administer this medication should be detailed in order to provide accurate information to the relevant health care professionals who carry a review of the person`s medication. Medication removed from its packaging and not administered should be labeled at the time to reduce the risk of recording errors when returning medication to the pharmacy for disposal. Catering tasks are undertaken by the care staff on duty during the late afternoon/early evening. Therefore, a review of these duties should be carried out to ensure sufficient staffing levels are maintained to meet the needs of the people who are living here. The manager is in the process of reviewing the induction programme carried out with newly appointed staff. The current programme does not include arrangements for regular supervision sessions to be held with them during this period. This needs to be addressed as part of the review of the induction programme. CARE HOMES FOR OLDER PEOPLE Redbrick Court Care Centre High Street Wordsley Stourbridge West Midlands DY8 5SD Lead Inspector Linda Elsaleh Key Unannounced Inspection 10:30 17th March 2009 X10015.doc Version 1.40 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 Redbrick Court Care Centre DS0000004896.V374225.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redbrick Court Care Centre Address High Street Wordsley Stourbridge West Midlands DY8 5SD 01384 571752 01384 75391 lobleyhill@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Care Centres Limited 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) Tracy Mancini Care Home 38 Category(ies) of Dementia (26), Old age, not falling within any registration, with number other category (12) of places Redbrick Court Care Centre DS0000004896.V374225.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 only to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 26 Older People (OP) 12 The maximum number of service users to be accommodated is 38. 2. Date of last inspection 24th April 2007 Brief Description of the Service: Redbrick Court Care Centre is a large detached property, which has been considerably extended and improved. The home is currently registered for thirty-eight people. The home is situated in its own grounds, set back from the main Stourbridge to Wolverhampton Road, near Wordsley. There is ample parking at the front of the building and extensive gardens at the rear. The home is on three floors with the lower ground floor accommodating the laundry. The bedrooms are located on the ground and first floor with access to the first floor provided by a passenger shaft lift. There are thirty-two single bedrooms of which sixteen have en-suite facilities and three double bedrooms with two having en-suite facilities. Toilets and bathrooms are situated on the ground and first floor and a fitted with the appropriate aids and equipment. Communal areas consist of a number of lounges and two dining rooms. A redecoration and refurbishment programme is being carried out on a phased basis. The manager should be contacted for information about the current fees for this service. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 17th March 2009. The purpose was to assess the service’s performance against the key standards in the National Minimum Standards for Care Homes for Older People and report on the progress made to address issues raised at the previous inspection. Our findings are based on the information received by us, the Commission for Social Care Inspection (CSCI) and includes the comments made on the surveys returned from people living at the home, their relatives and staff. We looked at the documents and records kept by the service during our visit. The files of two people who live at the home and two staff were looked at in detail. During the visit we spoke to the manager, staff, people receiving a service and visitors to the home. What the service does well: What has improved since the last inspection? The requirements made at the previous inspection have been addressed. The service continues to improve the environment for the people who live here and it has made suitable arrangements to reduce the risk of infection within the home. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 6 A person-centred approach to care planning is being implemented. This involves better consultation with individuals about needs, personal preferences and interests. Where appropriate, this includes discussions with her/his relatives. Regular discussions are held with people about menu planning and the service provides a choice of meals that meets the individual’s dietary needs and personal preferences. A regular supervision programme has been implemented to support staff to carry out their duties. An annual appraisal is undertaken to discuss the individual staff member’s performance and identify her/his training needs. A training programme has been produced for all staff and includes abuse awareness to ensure people are protected from harm. The training for caring for people with dementia and dignity in care has led to a more confident delivery of service to the people who live here. What they could do better: The service needs to improved arrangements to ensure the areas identified in this report remain free from malodours at all times. A programme of work should be identified and implemented for the re-decoration and refurbishment of the kitchen. In general the service has good systems for the handling and administration of medication. However, detailed protocols should be kept accessible to staff for administering “as required” medication prescribed to calm or sedate. This is to ensure a consistent approach is followed. Recordings of the decision made to administer this medication should be detailed in order to provide accurate information to the relevant health care professionals who carry a review of the person’s medication. Medication removed from its packaging and not administered should be labeled at the time to reduce the risk of recording errors when returning medication to the pharmacy for disposal. Catering tasks are undertaken by the care staff on duty during the late afternoon/early evening. Therefore, a review of these duties should be carried out to ensure sufficient staffing levels are maintained to meet the needs of the people who are living here. The manager is in the process of reviewing the induction programme carried out with newly appointed staff. The current programme does not include arrangements for regular supervision sessions to be held with them during this period. This needs to be addressed as part of the review of the induction programme. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 7 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. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 4 Quality in this outcome area is good. People who may wish to come to live at the home are provided with the information they need to make an informed choice about where to live. The service undertakes an assessment of each person’s needs and provides written confirmation that it is able to meet her/his needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A copy of the service’s Statement of Person and additional information is on display in the reception area. Five of the six people living at the home told us they were provided with good information about the service before coming to live here. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 10 We looked at two people’s files in detail. These contained copies of information and assessments carried out by health/social care agencies. The service carries out its own assessment of needs and provides written confirmation it is able to meet the person’s needs prior to a place being agreed. Assessments are carried out by the manager and/or senior staff. They visit the person in their own home or the place they are being accommodated. The staff team have received training in caring for people with dementia. The information we looked at on the file of a person who has recently come to live at the home shows the service has introduced a person-centred approach to its assessment process. Both the files contained care plans based on the person’s needs assessments. The same assessment process is followed for people requesting a short-term/respite service to ensure their needs and personal preferences will be met during their stay. The service invites people and/or their relatives to view the bedroom and bring small items of furniture and personal possessions. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. People’s care needs are set out in their care plans and are met according to their personal preferences. They are treated with respect and their privacy and dignity is maintained. The arrangement for the storage and administration of medication promotes and protects the health and well being of the people who live here. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person has a nominated care planner and key worker who are responsible for ensuring the care plan is up to date. Records are available to show a regular review of the individual’s care plan is undertaken. We looked at the care plan for an established resident and a person who has recently come to Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 12 live at the home. These are based on their assessed needs and personal preferences. Both provided good information about how their needs are to be met. Risk assessments have been undertaken to protect people’s health and well being such as protection from falls. Care plans show some people require support from two staff. Staff spoke to us about one person who has been supported to maintain her/his independence, but who is now requiring more assistance with her/his personal care. This is identified in the records kept by staff and in the person’s care plan. People who responded to our survey told us they have good access to their GP and other community health care professionals. Details are kept of appointments and visits with health care professionals such as the dentist, optician, chiropodist and community nurse. There is evidence of regular monitoring of individual health care needs. Staff told us advice is sought where any concerns are identified. We saw one person receiving a visit from her/his GP in the privacy of their own room. People also have the choice of using the home’s treatment room. The service has good arrangements for the safe storage of medication. The senior staff team are responsible for the handling and administering of medication. They are trained to an advanced level and for the monitored dosage system used in the home. The manager told us training had been provided for two experienced members of staff and they will be required to complete an in-house competency test before being given responsibility for handling medication. We looked at the medication records for four people. The recordings on the medication administration record (MAR) sheets show appropriate codes are being used. These identified times when, for various reasons, medication had not been administered. These tablets were stored separately, but had not been labelled. It is advisable for staff to label these tablets at the time. This will reduce the risk of recording errors when returning medication to the pharmacy for disposal. Some people are prescribed “as required” medication to sedate or calm. A protocol for administering this medication should be kept easily accessible to staff. This will ensure the medication is administered according to the protocol. Detailed records of the decisions taken to administer this medication will provide accurate information to the relevant health care professional for when they are reviewing the person’s medication. The senior member of staff told us of the arrangements in place for a person to administer their own medication. This demonstrates that the service supports people, where possible, to maintain their independence. However, this practice was not clearly described in the person’s records. The senior staff member told us the person’s records would be amended. People were observed being treated with respect by staff who addressed them by their preferred name. Staff told us they feel supported in meeting people’s Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 13 personal care needs and respect the individual’s right to dignity and privacy. They have attended Dignity in Care seminars and the service has two designated Dignity Champions who monitor practice within the home. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. People are helped, wherever possible, to follow their preferred lifestyle and provided with a varied activity programme. They are able to maintain relationships with family and friends. A choice of nutritious meals is provided in pleasant surroundings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service employs an activity organiser who develops programmes and arranges social events based on the interests of people living in the home. These are on display on the notice board with a monthly newsletter which includes forthcoming events and celebrations. A local minister visits the home each month. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 15 People are able to receive visitors at any time and in private. They are able to choose which room they wish to use, the visitors lounge or their bedroom. Visitors spoken to said they are made welcome. We saw a group of visitors being serviced with tea and biscuits. One visitor told us their relative used to be a keen dart player. A small lounge in Crystal Unit has been re-furbished to look like a ‘pub’. It has a bar, dartboard and pool table. The people who live in this part of the house were identified by staff as enjoying group activities more than those living on Stuart Unit. However, some people on Stuart Unit like going out in small groups shopping or for short outings. Discussions are held with individuals about their preferred routines. For example, the time they go to bed and get up in the morning. They are also encouraged to express their views about the day-to-day running of the home. People are provided with a choice of meals that meet their dietary needs and personal preferences. People who expressed a view told us they are satisfied with the quality and variety of meals served. Cool drinks are available in the lounges and hot drinks provided on request. Nutritional assessments are undertaken by staff and a record is kept of meals taken. A copy of individual’s dietary needs, likes and dislikes are kept in the kitchen. Most people choose to take their meals in the dining room. The tables were laid appropriately for the meals being served and included condiments and drinks. Comments are regularly sought about the quality of meals served. These are recorded in a book kept for this purpose and is regularly monitored by the cook. Breakfast and the mid-day meals are prepared and served by a team of catering staff. However, during the evening a member of the care staff team is nominated to take over these duties. This involves serving the evening meals, suppers and other associated tasks. The manager is advised to undertaken a review of care and catering duties at this time of the day to ensure all the needs of people living at the home are being appropriately met. There are training programmes for catering and care staff. This includes basic food hygiene and nutrition. Records kept by the catering staff are in good order. This includes cleaning schedules, food storage temperatures and environmental risk assessments. The kitchen has not been refurbished for some time. Staff reported equipment needed to be updated and expressed concern about the floor covering. The cook told us that a representative from the company visited early in the year to assess plans for the kitchen. However, no further information had been received. We saw damaged and missing wall tiles and told the casing for the boiler had been removed by the engineer. The manager is advised to address this and discuss with the company timescales for making improvements to the kitchen. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. People who live at the home are confident any concerns they have are listened to and acted upon. The home has procedures and systems in place to protect people from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A copy of the complaint procedure is on display in the reception area and included in the Service User Guide. Information provided to us by the service states two complaints have been received by them during the last 12 months. The records show these have been investigated and appropriate action taken. The complainants have been informed of the outcome of the investigation into their complaint. People who responded to our survey and those we spoke to during this visit told us they had been provided with information about how to make a complaint and know who they would speak to if they were unhappy about something. The manager holds a regular ‘drop-in’ surgery and relatives are welcome to discuss any issues or concerns they may have. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 17 The service has a policy and procedures for safeguarding adults from abuse. Arrangements are made for staff to attend abuse awareness training. Information provided to us by the service show no safeguarding issues have been raised with them during the last twelve months. No concerns were brought to our attention during this visit. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. People live in a homely, clean and safe environment which meets their needs. However, a more effective system for managing odour control in some communal areas will further improve the environment. The service has suitable infection control procedures that a followed by staff who have been trained in this area. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is separated into two units, Stuart, where people who are elderly and frail live, and Crystal, where people with mild to moderate dementia live. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 19 The reception area is welcoming and a variety of information is on display about the service. A team of domestic staff are employed to ensure the home is kept clean and tidy. The manager told us a new member of staff would be joining this team once the relevant employment checks had been satisfactorily completed. We noticed a malodour in reception on our arrival and in the corridor on Crystal Unit. This was brought to the attention of the manager. There are a number of small lounges on both units so people living here have a choice of where they would like to sit in. All lounges are decorated and furnished in a style that is familiar to the residents. For example, ornaments popular with their generation and an old style telephone. Large wall clocks enable people to see the time with ease. We observed one resident commenting that two paintings would look better if they were moved to another wall. Staff told her/him they would ask the handyperson to speak to them about it. Bedrooms are generally single and people are encouraged to bring personal possessions such as photographs and pictures. Bathrooms are situated on both units and appropriate aids and equipment are provided. We spoke to several people in different lounges who told us toilets were situated close by and staff were usually available to provide assistance when required. Relatives and staff surveyed commented there are areas of the home that need attention in respect of redecoration and refurbishment. A programme for the upkeep of the premises has started and the manager told us further work is due to start in the near future. The service has satisfactory infection control procedures and colour coded linen baskets have been purchased to minimise the risk of infection. Information for the control of substances hazardous to health (COSHH) is kept easily accessible for staff. Training in the control of infection is provided to all staff. Each unit has its own garden and is accessible to people regardless of their disability. Paths have been laid to enable people to wander safely if they wish to. During the winter months the garden has not been used and the manager told us particular attention will be given by the gardener to ensure it is a pleasant area for people to use as the weather improves. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. The people who live in this home are cared for by a competent and trained staff team. However, a review of staffing levels should be undertaken to enable people to be confident that sufficient staff are on duty at all times. People are protected by the good recruitment processes followed by the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager and deputy were on duty on the day of this visit. Four care assistants were identified on the rota; 1 based on Stuart Unit, 2 based on Crystal Unit and 1 care assistant providing individual care to a person whose needs were being re-assessed. The senior member of staff’s duties includes providing support to both units, as required, throughout her/his shift. Another senior member of staff, who was not identified on the rota, arrived to do the routine re-ordering of medication. The staffing levels did appear to meet the general needs of the people currently living here. However, additional staff was not seen during busy times of the day; such as mealtimes. The manager Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 21 told us staffing levels are increased as the occupancy levels rise and/or the needs of the people living here change. The service has not employed agency or bank staff to cover absences/holidays. The manager told us absences are covered by the staff team, providing people with consistent care from staff who are known to them. Staff who responded to our survey commented on the difficulty sometimes experienced in covering short notice absences by staff. As stated, early in this report, the manager is advised to review staffing levels, especially with regards to the additional duties care staff are required to carry out during the late afternoon/early evening. Information provided to us by the service shows 8 of the 20 care staff employed hold an NVQ (National Vocational Qualification) Level 2 or above. There has been a high turnover in staff during the last 12 months. The manager reported that although this did have an unsettling affect on the home, the service being provided has improved following a change in the staff team. All newly appointed staff are registered for NVQ training. The service has produced an annual training programme for staff. This covers a wide range of client-centred and health & safety courses. Training records of courses attended are kept and enables the manager to plan refresher and update training courses in a timely manner. We looked at the files of two staff in detail, one of whom has been recently employed. The recruitment records for both contain references, interview notes and confirmation that satisfactory CRB (Criminal Record Bureau) checks were received prior to the person being employed. A newly appointed member of staff receives ‘on-floor’ supervision by a senior member of staff or an experienced care assistant as part of their induction programme. However, the records kept of this process are incomplete. The manager told us arrangements are being made to review the induction process. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is good. People live in a home that is run in their best interests by an experienced and suitably qualified manager. There are systems in place for promoting good standards of care and safeguarding people’s interests. The staff team are supported to carry out their duties by a planned programme of supervision. Newly appointed staff would benefit from similar arrangements being made as part of their induction/probationary period. There are procedures and systems in place to protect the health, safety and welfare of people who live at the home and the staff. This judgement has been made using available evidence including a visit to this service. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 23 EVIDENCE: The service is run by an experienced and suitably qualified manager who has been in post over a year. She attends periodic training to update her knowledge and skills. A planned approach has been taken to address previous shortfalls in the service such monitoring staff practice and providing a comprehensive training programme. Southern Cross has a quality assurance system for monitoring the performance of all its services. A representative of the company visits the service as part of the audit process. Redbrick Court also carries out its own audits on all aspects of the service for which records are kept. For example, concerns and complaints, accidents, meals and mealtimes and resident and staff meetings. Surveys are one of the tools used by the service to obtain the views of people living at the home and other stakeholders. The findings from this assessment of the service’s performance are used to produce an annual development plan for improvement. The service continues to operate a satisfactory system for handling and safekeeping of money. This includes keeping accurate records and obtaining receipts for all transactions made on behalf of the people living at the home. We looked a file for a staff member who had been employed for more than a year. There were detailed records of supervision sessions held to discuss practice issues and identify training needs. An annual appraisal of this person’s performance was carried out with them in November 2008. This shows us the service takes a planned approach in supporting staff to carry out their duties. However, the file for a newly appointed member of staff did not contain any records of formal meetings held with them during their induction/probationary period. We discussed the benefits of arranging regular, planned supervision sessions with new staff, such as providing good opportunities to discuss practice issues and/or any concerns at an early stage. The manager agreed to include this in her review of the induction process. Scheduled re-decoration and refurbishment of the home is arranged by the company, such as the fitting of carpets. The handyperson carries out general maintenance work and routine repairs. Appropriate contract arrangements and records are available for the servicing of appliances and equipment. Arrangements are made for staff to attend health and safety training courses. These include first aid, fire safety, infection control and moving and handling. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 X 3 3 X n/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 2 X 3 Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations Medication removed from packaging and not administered should be labelled at the time to reduce the risk of recording errors when returning it to the pharmacy for disposal. A protocol for administering “as required” medication prescribed to calm or sedate should be kept accessible to ensure a consistent approach is followed and detailed records kept of the decision to administer to inform health care professionals when reviewing her/his medication. Missing and broken tiles in the kitchen and the cover for the boiler should be replaced. A programme for the refurbishment of the kitchen should be produced and implemented. Suitable arrangements should be made for controlling But DS0000004896.V374225.R01.S.doc Version 5.2 Page 26 2. OP9 3. OP15 4. OP26 Redbrick Court Care Centre 5. OP27 6. OP36 it malodours in the reception area and the corridor on Crystal Unit. All duties required to be carried out by care staff should be reviewed to ensure staffing levels are sufficient at all times to meet the needs of the people who live at the home. Newly appointed staff should be provided with planned supervision sessions as part of their induction/probation period to enable practice issues and any concerns to be addressed promptly. Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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. Extracts may not be used or reproduced without the express permission of CSCI Redbrick Court Care Centre DS0000004896.V374225.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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