Care Home: Redcote House Residential Care Home

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What the care home does well The home is comfortable, homely, clean and well-run and there is a happy atmosphere. Residents and relatives with whom we spoke, and who filled in the questionnaires said they were happy with the care they were receiving. They said that the staff treat the residents with respect and dignity. They spoke well of the staff team and acting manager. The staff were observed to be kind and polite when speaking with and caring for residents. They showed that they know how to protect residents, and made sure that they feel safe living at the home. What has improved since the last inspection? CARE HOMES FOR OLDER PEOPLE Redcote House Residential Care Home Redcote Drive Lincoln Lincolnshire LN6 7HQ Lead Inspector Vanessa Gent Unannounced Inspection 10th June 2008 13:45 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 Redcote House Residential Care Home DS0000065539.V366234.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. Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redcote House Residential Care Home Address Redcote Drive Lincoln Lincolnshire LN6 7HQ 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) 01522 500796 redcotehouse@tiscali.co.uk 1st Care (UK) Limited Mrs Linda Gostelow Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories: Old Age, not falling within any other category (OP) 18 Mr Bhandal must comply with his Action Plan and the agreed timescales. 11th June 2007 Date of last inspection Brief Description of the Service: Redcote House is a large detached house, which has been adapted to accommodation and personal care for up to eighteen people of both sexes over the age of 65 years. It is situated in a cul-de-sac off a main road, in a quiet residential area to the south of the city of Lincoln. The home is within walking distance of local shops and close to a bus route into the city centre. The home has two floors with a stair lift to the first floor. Ten of the bedrooms are single; three of them have an en-suite toilet. Communally, there are bathrooms and toilets near to residents’ rooms and communal areas. There is a porch running the length of the front of the home, which provides a pleasant outside seating area for residents. There is a grassed area around the home but the garden is not fully enclosed or secure. Car parking facilities are to the rear of the property. The philosophy of care is based on understanding the individual and empathising to provide the best care possible. The statement of purpose and service user guide, which give residents information about the home, are readily available to them and their families. The fees range from £351 to £448 per week. Additional costs are to be paid by the individual for hairdressing, chiropody, newspapers or magazines, private telephone installation and calls, and escorting people to hospital when they need to go. Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. An unannounced visit was made to the home as part of a key inspection. It started at 13.45 and lasted 5 hours. The manager had completed a questionnaire called the Annual Quality Assurance Assessment (AQAA) giving important information about the service and this was used to contribute to the inspection process. Questionnaires had been returned from three residents, some of whom had been supported to complete them by a staff member or relative. We also received surveys from five relatives, two staff and a healthcare professional. Information from these sources, as well as that which we hold about the service, was used to plan the visit and produce this report. The main method of inspection used is called ‘case-tracking’, which involves selecting a proportion of residents, and tracking the care they receive through the checking of records, discussion with them, the care staff and observation of care practices. Our visit to the home focused on whether key standards and requirements from previous inspections had been met and to check on how people feel about the service provided. The care received by three people was followed in detail to ensure the health, safety and welfare needs were fully met and that they supported to maintain their dignity, autonomy and choice. Two staff members on duty and four of the ten residents, including those being case-tracked, spoke with us. Residents spoke about their experience of living at the home. Their personal records, general house records and staff records were looked at and the way care was given to the residents was observed. From the questionnaires we received, most were positive about the level and quality of care given. All ticked that there are activities they can take part in, that staff always or usually listen to what residents say and that meals are usually liked. Any comments we received will be mentioned in the main body of this report. A partial tour of the home was made and a sample of other records examined. The manager was present throughout this inspection. Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: 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. Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 7 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 Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 8 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, 2, 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Enough information is provided to help people choose where to live. The assessment processes in place are used to ensure that the care team can meet each new person’s individual needs. EVIDENCE: The statement of purpose and service user guide, which give people information about the home, are readily available to them. This information alongside being able to visit the home and see how it operates helps prospective residents to make an appropriate decision about coming to live at the home. One person told us, “I came from [another care home] and was told it was a nice, friendly home.” Each person at the home had a contract of terms and conditions, in which the number of the room occupied is also recorded. Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 9 Assessments of people’s needs are made by the manager and care team before residents are accepted into the home, to make sure the home can meet the needs of those who choose to live there. Records were available to show this. Visitors to the home said that staff welcomed new residents and their relatives in a friendly and helpful manner. The home does not provide intermediate care. Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 10 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. This judgement has been made using available evidence including a visit to this service. People’s healthcare and personal needs are met by staff who understand their wishes and preferences. They are cared for as individuals, respected and treated with dignity by staff and the acting manager. EVIDENCE: The acting manager showed us how she had worked to develop and improve the care plan system in place at the home. The care plans we saw of people we case-tracked were comprehensive, clear to read, set out in sequence and showed the involvement of each individual concerned. A healthcare professional who visits the home told us during our visit that they were in regular contact with the home. They did not identify any problems and said, “the staff are smart and helpful.” A nutritional assessment was in place to help support one person with special dietary needs. Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 11 People who live at the home needed help in order to take their medicines in a safe way. The medication chart for each person, showing who medicines are for and what time they were needed had a photograph and details about that person so staff members could easily identify them. The acting manager showed us that staff are in the process of adding other extra details of how each resident likes to take their medication, so that staff can fulfil the residents’ wishes in this respect. The supplying chemist does three monthly audit visits to assist the staff to maintain safe and effective practices. Staff know how to record medicines that are for only when the resident wants or needs them or when necessary. A policy for ‘homely remedies’, that is, those not prescribed by the doctor, is in place. Residents said they are treated with dignity and respect. Records showed most staff had completed a distance-learning course in equality and diversity to help them respect the residents’ individuality. Most of the residents, in their surveys, said they were listened to and things acted upon. Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 12 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 adequate. This judgement has been made using available evidence including a visit to this service. People are able to make choices and decisions about their daily lives and enjoy activities provided but would benefit from more quantity, variety and choice. A nutritious and balanced diet is available for residents although the choice may is limited at times and may not suit all tastes. EVIDENCE: Before making our visit to the home people told us there were activities available that they could take part in and that they enjoy. However during our visit people said they do not currently have meetings together with the staff to discuss and agree activities or contribute ideas for new activities. When asked what activities were available, some residents said, “There’s a bit but not every day”; “Sometimes we have a quiz. There’s two big screen TVs.” “We get trips out sometimes.” The home now has an activity organiser who works part-time. The acting manager told us how the activity organiser keeps clear, descriptive records of the activities offered and engaged in by people. We saw the records to confirm these. The care plans show what people like, want and enjoy so that staff Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 13 members can use this information to plan activities. The activity organiser has a plan for how she intends to continue to improve the activity provision in the home. The acting manager told us she is keen for the home to join the charity, NAPA (National Association of the Provision of Activities for Older People). She said that this would help the activity organiser to receive more training and to provide a greater variety, number and quality of activities for people. People told us that they are able to make their own personal choices about their daily lives. They also said when they needed support they felt able to seek it and said that staff asked them what they wanted and helped them to fulfil the everyday decisions they made. Visitors to the home said they feel welcome and that staff are always smiling and cheerful. A visitor said they always get offered a ‘cup of tea’ and enjoys visiting at the home. With regard to the meals provided by the cook, there were menus available for people to choose from and a staff was able to confirm that meals are provided in line with the choices on offer. People told us they like the meals, and that “the food’s pretty good”. One person did say they felt there could be more variety and added “Could do with more choice of fillings for the sandwiches”. We spoke with the cook about this and she confirmed they would review the choice of fillings on offer to make sure a wider range was offered to suit all tastes at the home. Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 14 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. This judgement has been made using available evidence including a visit to this service. Residents are protected, supported safely and with consideration by staff who are well trained. EVIDENCE: People told us that they always know who to go to with a complaint. In the relatives’ surveys we received before our visit, people told us that the acting manager appropriately if and when complaints or concerns are raised. The complaints procedure is available to all residents in the statement of purpose, a copy of which is kept in the entrance hall. The acting manager told us that no complaints or concerns had been made directly to her since she came into post at the beginning of the current year. She showed us the home’s policy for how to deal with concerns and complaints, and the time they had set in which they were to be dealt with. One carer had raised a concern about aspects of the care of their relative whilst living at the home but said they would write a letter about it directly to the provider. At the time of the inspection visit, the provider had received the letter from the carer. He told us that he would deal with the matter sympathetically and within the timescale in their complaints policy. Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 15 At the time of the inspection visit, one safeguarding adults issue had been referred to social services following concerns raised and the provider and acting manager were co-operating fully with this matter. One person told us, “The staff are cheerful and happy”. A visitor said that the resident she visits has always got a smile of her face, and she believes it is because the staff care for her so well. Staff said they are well trained and know how to protect people and training records confirmed this. Staff members told us about how they support people to keep them safe, how they would report any concerns and we observed a good rapport between residents and staff on duty during the inspection visit. Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 16 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. This judgement has been made using available evidence including a visit to this service. The home provides a clean, comfortable, hygienic and safe environment for the people who live there. EVIDENCE: Before we made our visit people told us that the home is always clean and fresh. During our visit we saw that work has been done since the last inspection to improve the outside of the building and décor inside. People told us that their rooms are decorated in the colours they had chosen. Their rooms were personalised, clean and homely. There were new carpets in the corridors and lounge, which had been fitted since the last inspection. The communal areas and the kitchen were clean, tidy and smelled fresh, and it was confirmed by a visitor that this is always the case. Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 17 A healthcare professional who visits the home commented, “Since the management change, the décor and surroundings are greatly improved.” Measures are in place to maintain the hygiene standards of the home. Records were seen that confirmed this, including the water temperature records, fire safety checks and checks to prevent legionella. The acting manager has produced a twelve-month plan for maintenance and improvement of the premises. Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 18 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. This judgement has been made using available evidence including a visit to this service. Residents are cared for by a staff team who have been recruited and trained appropriately and have the time knowledge and skill to fulfil their roles. EVIDENCE: The AQAA told us that eight staff had left in the past twelve months, most of these had been at the latter end of the last or beginning of the current year before the present acting manager was fully in post. Information provided also showed that most of the staff team are being supported to take nationally recognised qualifications as part of the overall training plan. Staff members told us they had the training, skill and experience to care well for the residents. One relative felt the service could improve with more “Training, reliable staff, communication.” People told us they feel comfortable with the staff and were complimentary about the care they provide. When asked if staff were always available when needed, four said always, one said usually and one, sometimes, with the added comment, “maybe busy with other residents when have needed help”. Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 19 One person we spoke with said she never had to wait; “they’re always flitting around and come straight away when I call for them.” The staff duty rota showed there are always two staff members, as well as, during the daytime, the acting manager, a housekeeper, a cook and part-time activity organiser to support ten people who currently live at the home. All the people we spoke with told us they felt that staff are aware of and respect diversity: “any religious beliefs or needs are always taken into consideration i.e. – food, prayers and disability”. One staff member told us that the induction provided was comprehensive and prepared them well for their caring role. They had worked at the home at a previous time and said they had confidence in the acting manager and felt that things were improving at the home. Staff members said the staff were a good, close team. Each could speak up and their opinion was asked for by the manager, which helped to make them feel valued. Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 20 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, 32, 33, 35, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The acting manager and staff are an enthusiastic team that keep the residents safeguarded and comfortable. EVIDENCE: We discussed with the acting manager the importance of completing her registration with the commission. Both the acting manager and provider agreed to complete this without further delay. The acting manager said that ‘the provider is supportive and he funds requests that she makes without any problem.’ Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 21 Of the acting manager, one staff said, “She is really good. She’s approachable”. “She’s always about and always deals with any issues straight away”. And of the deputy manager /senior carer, “she is brilliant”. A visitor said of this particular staff, “[She]’s absolutely lovely; she’s a gem”. And a resident said, “She’s the best, so bubbly and always happy and smiling”. The provider visits, checks and audits the service provided every month and sends us a copy of his report. For those residents whose personal allowances are looked after by the acting manager, there are clear records and receipts for all transactions. Most residents’ finances are dealt with by their families or representatives. Formal one-to-one meetings take place with all care staff about six times per year. Staff told us they were well-supported by the acting manager. A comprehensive health and safety policy in place includes electrical, water and equipment testing and management, fire safety, drills and alarm testing and food management. These are updated, as described in the AQAA, by the acting manager. One resident said, “They’re trying to get things going and improving all the time”. “They [the staff] always wear a smile. They don’t forget the residents are individuals.” Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 22 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 3 3 3 X 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 3 X 3 Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 23 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. 2. Refer to Standard OP12 OP15 Good Practice Recommendations The quantity and variety of activities available should fully reflect the wishes and preferences of the residents. The quantity and variety of foods on offer to people should always be what they choose and want, to satisfy their needs and wishes. Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 25 © 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 Redcote House Residential Care Home DS0000065539.V366234.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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