Care Home: Redbricks Care Home

What the care home does well The homes assessment procedures were very thorough and care plans had been structured to ensure staff recognize the needs of the people they support. Observation of practice and discussion with the staff member on duty confirmed the staff team had been provided with appropriate training to assist them in understanding and meeting the needs of the people in their care. The relatives of three people living in the home told us they are made welcome when they visit and that they were satisfied that the staff are available when needed and they had no concerns about the care being provided. One person said, "The staff are always friendly, kind and caring. Redbricks is like a home from home. It`s just the right size with just the right number of clients". One Person we spoke to said they enjoyed the quality and variety of food being provided and activities organized. The person said, "I enjoy my meals and we get plenty to eat" The care plans we looked at had recorded the leisure and social interests of people on their admission into the home. These included playing cards, dominoes, listening to music, reading, completing puzzle books and receiving their visitors. The staff member on duty was observed spending time with people and assisting them to participate in an activity of their choice. The manager told us the staff arrange individual and group activities throughout the day to ensure the people in her care are entertained and stimulated. The staff employed at the home all have experience working with people who have dementia and have been well trained and are competent to do their jobs. Observation of care practices throughout the day confirmed the people they support are treated with respect and dignity. Staffing levels were sufficient for the number of people being accommodated. The staff were observed throughout the visit having enough time to deliver care and support without being hurried. The people we spoke to told us the staff were always available when they needed them and they were happy with the care being provided. The home has been decorated and furnished to a good standard to ensure the comfort of people who live there. A tour of the building confirmed the home was clean, hygienic, free from offensive smells and was providing a safe environment for people to live. The people we spoke to and their relatives told us they were happy with the standard of accommodation provided. What has improved since the last inspection? This is the homes first key inspection. What the care home could do better: Staff working at the home must have all relevant information in place including two written references before they commence their employment. This will confirm they have been recruited properly and provide protection for the people in their care. Key inspection report Care homes for older people Name: Address: Redbricks Care Home 512 Queens Promenade Thornton-Cleveleys Lancs FY5 1PQ     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: Wesley Cornwell     Date: 0 8 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 24 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 24 Information about the care home Name of care home: Address: Redbricks Care Home 512 Queens Promenade Thornton-Cleveleys Lancs FY5 1PQ 07920519705 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): redbricks@nightingalesnursinghome.com Nightingales Care Ltd Name of registered manager (if applicable) Mrs Jacqueline Pointon Type of registration: Number of places registered: care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The registered person may provide the following category of service only: Care home only - code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia - code DE The maximum number of service users who can be accommodated is: 9. Date of last inspection Brief description of the care home Redbricks is registered to provide personal care for nine people of both sexes whose primary care needs are dementia. The home is situated on the sea front in Bispham and comprises of the following accommodation:- open plan lounge/dining room, kitchen and laundry facilities. Bedrooms are located on the ground and first floors and comprises of nine single rooms with ensuite facilities. A passenger lift is available to facilitate access between the ground and first floor. The home has a ramp at the front entrance to enable access for people of all abilities. The home has a Statement of Purpose and Service User Guide providing information Care Homes for Older People Page 4 of 24 9 Over 65 0 Brief description of the care home about the care provided, the qualifications and experience of the owners and staff and the services people can expect if they choose to live at the home. A copy of the Service User Guide and most recent inspection report is available from the manager to help people to make an informed choice whether to move into the home. The fees charged by the home are four hundred pounds to four hundred and fifty pounds covering all aspects of care, food and accommodation. The manager provided this information on the 8th December 2009. Care Homes for Older People Page 5 of 24 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: This unannounced visit was undertaken as part of the homes first key inspection since its registration with the Care Quality Commission in June 2009. The visit commenced at 9.30 am and took place over 4 hours. Prior to the visit the manager of the home completed an Annual Quality Assurance Assessment form (AQAA) providing detailed information about the service they are providing. The AQAA is a self assessment and data set, which providers are asked to complete each year and is one of the main ways that we obtain information about how they are meeting outcomes for people in their care. A number of people living at the home were contacted prior to the visit and their views about the home have been included in the report. Staff, care, maintenance and financial records were examined during the visit and a full tour of the premises was undertaken with the manager. Care Homes for Older People Page 6 of 24 What the care home does well: What has improved since the last inspection? What they could do better: 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. Care Homes for Older People Page 7 of 24 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 24 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 24 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. The admission and assessment procedures were clear to ensure the care needs of people were met. Evidence: We looked at the care plan records of two people and found they had full assessment information in place including their religious/cultural and relationship needs. The assessment had identified the nutritional needs of the people and risk assessment information advising staff members of the action to be taken to minimize identified risks and hazards. The staff member responsible for the preparation of meals told us they are provided with information about people with special dietary needs and these are accommodated. The assessment had also identified that both people were in the early stages of dementia and the level of care and support they would need. The assessment had documented that both people were able to communicate with the staff in respect of their needs and personal preferences regarding their daily routine. Care Homes for Older People Page 10 of 24 Evidence: The people we spoke to said they were very happy with the care being provided and told us their needs were being met. One person said, I visited the home with my brother before I moved in and they told me how they would look after me. I am perfectly happy with my care and have no complaints. This home doesnt provide intermediate care. Care Homes for Older People Page 11 of 24 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. Promotion of health is taken seriously and peoples welfare is closely monitored and were met. Evidence: Individual records are kept for each person with a plan of care setting out the action that is to be taken by support staff to ensure all aspects of health, personal and social care needs of the people living at the home were being met. Significant events had been recorded and daily entries made setting out the care given. The care plans were structured and were being reviewed regularly and updated to reflect any changes needs and these were being actioned as required. We looked at the records of two people and these described their healthcare needs. Discussion with the manager and staff member on duty confirmed they were fully aware of the healthcare needs of people living in the home and these are monitored and their care plans kept up to date. Entries made on care plans showed good communication between the home and healthcare professionals. Daily entries made on the care plans confirmed staff members were following the instructions of healthcare Care Homes for Older People Page 12 of 24 Evidence: professionals and an appropriate level of care was being provided. We spoke to people about the care they were receiving and were told they liked living at the home and were being well treated. One person said, I am happy with my care and like living in the home. I have found the staff to be kind and helpful. The relative of one person said, The staff are always friendly, kind and caring. Redbricks is like a home from home. Its just the right size with just the right number of people. Observations made during the visit confirmed the people who live there have the freedom of the home and could choose to spend time in the lounge or their bedroom. On person we spoke to told us he went to his room when he wanted some privacy and this was always respected by the staff. The medication practices we observed were safe and good records had been maintained. The staff members responsible for the administration of medicines had received accredited training to ensure they had basic knowledge of how medicines are used and how to recognize and deal with problems in use. Care Homes for Older People Page 13 of 24 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. Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. Evidence: We spoke to people about the routines in the home and they told us they were flexible and they were able to make their own decisions about how to live their lives. One person said, I like to sit in the lounge watching television and I go to my room when I want a bit of privacy. People spoken to told us they were happy with arrangements in place for receiving their visitors. The relative of one person was observed visiting and was seen to be made welcome by the staff member on duty. The staff member responsible for the preparation of meals was able to confirm they had information about people with special diets and personal preferences and told us these were being accommodated. Menus were observed and found to be providing meals that were varied and nutritious. We spoke to people about the meals provided by the home and they told us these were enjoyable and they got plenty to eat. Meal times were served in a relaxed and unhurried manner. The staff member was Care Homes for Older People Page 14 of 24 Evidence: observed being very attentive to the needs of people who needed assistance. The manager told us each person has their leisure and social interests recorded on their care plan when they move into the home. She told us the staff arrange individual and group activities throughout the day to ensure the people in her care are entertained and stimulated. During the visit we observed the staff member on duty spending time with one person and supporting them to complete a puzzle book. The people we spoke to told us they were happy with the arrangements in place for social activities and these were varied and interesting. Care Homes for Older People Page 15 of 24 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. Complaints are handled well and taken seriously ensuring people feel listened to. Evidence: The home has a detailed complaints procedure, which is issued to all people on their admission. One person we spoke to said they knew how to make a complaint if they were unhappy. They told us they were happy and had no reason to make a complaint. The relatives of three people also confirmed they were happy with the care being provided by the staff and had no concerns about the service being provided. The Care Quality Commission has not received any complaints about the home. The home has a procedure in place for dealing with allegations of abuse. The staff member spoken to had received training in the protection of vulnerable adults and showed a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. The staff member told us they wouldnt hesitate to report any concerns they had about care practices to ensure people living at the home are protected from potential harm or abuse. At the time of this visit the Care Quality Commission had not received any safeguarding referrals about staff working at the home. Care Homes for Older People Page 16 of 24 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, homely, clean and safe environment Evidence: The home has been well maintained and decorated for the comfort of the people living there. On the ground floor there is a lounge and open plan dining room. A flat screened television is available for peoples entertainment. The homes communal bathroom is also located on the ground floor along with the kitchen and laundry facilities. The relatives of three people told us they were happy with the standard of accommodation provided and said they felt at home when they visited. The home has nine single bedrooms which all have ensuite facilities providing a toilet, hand basin and shower. A tour of the building confirmed bedrooms had personalised with people being encouraged to bring their own belongings on their admission into the home. One Person we spoke to told us they were happy with their room and said they had the choice of spending time on their own or in the lounge areas. Hot water temperatures were checked throughout the home and found to be delivering water at a safe temperature in line with health and safety guidelines. It was observed during the visit the home was clean and hygienic ensuring a pleasant environment in which to live. Care Homes for Older People Page 17 of 24 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. Staffing levels are sufficient to meet the needs of people living at the home but recruitment procedures are not robust potentially placing people at risk. Evidence: Staffing levels were sufficient for the number of people living in the home. The relatives of three people told us they were happy with the care being provided and said the people living in the home were well treated by the staff. The relative of one person said, The staff seem well trained. They listen to you and seem caring and comforting. The staff member we spoke to showed a good understanding of her role and responsibilities and felt she and her colleagues worked well as team to ensure the individual and collective needs of the people in their care were being met. The relative of one person said, No concerns about the care being provided. My husband is treated with care and dignity. I am very happy with my choice of home. Records show all staff members have access to a structured training and development programme ensuring the people in their care are being supported by a well trained and competent staff team. In addition 50 of staff members have achieved National Vocational Qualifications (NVQ) ensuring people are in the safe hands of qualified and competent staff. Care Homes for Older People Page 18 of 24 Evidence: We looked at the records of two staff members employed to work at the home and found that although a Protection of Vulnerable Adults (POVA) check had been completed two written references hadnt been received before they commenced their employment. The manager was reminded that all relevant information must be in place before new staff members commence their employment at the home. These records are required to confirm their suitability to work with vulnerable people and reduce any potential risk of harm to the people in their care. Care Homes for Older People Page 19 of 24 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. The home is well run and ensures the health and safety of staff and people living there are promoted and protected. Evidence: The manager has been in post since the home opened and has a number of years experience working with people who have dementia. She has achieved a relevant care qualification and is presently working towards achieving a recognized management qualification. She is well supported by the owner of the home who was present during this visit. Through discussion and observation of records we were able to establish the manager undertakes periodic training to ensure her knowledge and skills are updated and the home continues to be run well and for benefit of the people in her care. This included training about the Mental Capacity Act deprivation of liberty safeguards which had provided guidance for providers on their duties and responsibilities to apply for authorization if they felt it was in the best interests to deprive someone in her care of their liberty. Observations made during the visit confirmed people living in the home had choice of movement and were able to make their own decisions about their Care Homes for Older People Page 20 of 24 Evidence: lifestyle. The manager has in place informal quality assurance systems to gather the views of the people in her care about the service being provided. We spoke to the manager about introducing more formal quality assurance systems so that the relatives of people living in the home and other interested parties could comment on the standards they felt the home was achieving. The manager told us this was something she would introduce as she was interested to know what people think about the service she and her staff are providing. A self assessment form that the Commission had asked the manager to complete before this visit took place was completed and returned to us when we asked for it. The manager told us very briefly how outcomes for people in her care were being achieved. We discussed completion of the form with the manager and informed her she needs to provide more detailed information about how outcomes are being met for the people in her care and record areas she had identified for future development. The manager told us they do not retain monies on behalf of the people in their care. We were informed relatives are encouraged to accept responsibility for the personal finances of people moving into the home. We were told this policy ensures the financial interests of the people in their care are safeguarded. Inspection of maintenance records confirmed facilities and equipment was being maintained as required by health and safety legislation providing a safe environment for people to live. Care Homes for Older People Page 21 of 24 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 22 of 24 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 29 19 People who work at the 11/12/2009 home must be recruited properly and have all relevant information in place before they commence their employment. This will reduce the risk of employing anyone who is unsuitable to work with vulnerable people. 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 Care Homes for Older People Page 23 of 24 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. 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. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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