Care Home: Redwalls Care Home

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What the care home does well People who live in the home told the Inspector about the trips they had taken including, for one person, a visit to Gracelands and Nashville the previous year. Another person said he enjoys taking part in his chosen religion and community and is encouraged to attend services and regular weekly events. Staff were hugely enthusiastic about the home and the people who live there. They spoke very well about the registered manager and the organisation. The home provides many aids such as ceiling hoists, and bath and toilet aids that promote independence. The kitchen has a work surface that alters height at the touch of a button. The home has taken into account widths of wheelchairs and the ground floor is accessible to all people who live in the home. What has improved since the last inspection? N/A What the care home could do better: Some confidential documents seen in one area are to be stored securely. Much of the recording that has transferred with the people who live in the home is relating to children`s services. The registered manager agreed to make sure new recording format reflects the move to younger adults services and are to be reviewed and updated where necessary. The home has a clear and comprehensive complaints policy and procedure, the registered manager agreed to put a simplified version of the complaints procedure on display and make sure new people to the home receive a copy when they first move in. CARE HOME ADULTS 18-65 Redwalls Care Home Stodmarsh Road Canterbury Kent CT3 4AP Lead Inspector Wendy Gabriel Unannounced Inspection 4th February 2008 09:30 Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redwalls Care Home Address Stodmarsh Road Canterbury Kent CT3 4AP 01227 780796 01227455059 lindageorge@miles-of-smiles.org.uk admin@miles-of-smiles.org.uk Kent Kids Miles of Smiles 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) Miss Linda George Care Home 6 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disability (LD) Physical Disability (PD) The maximum number of service users to be accommodated is 6. 2. Date of last inspection Brief Description of the Service: Redwalls is a six bedded home for young people who have either a physical or learning disability. It is owned and run by the charity ‘Kent Kids Miles For Smiles’. It is a ground floor purpose built addition to the original house on the site. The upstairs of the house is for offices and staff facilities. People who live in the home have the use of the extensive ground floor and this area can accommodate wheelchairs. The home has many built in aids including unobtrusive ceiling runners for hoists, adjustable height baths and automatic bidet style toilets. The kitchen has a large area where the work surface level may be raised or lowered to a suitable height for people working in there. Redwalls is in a quiet country lane a few miles from Canterbury. There is a large area of private garden and grounds surrounding it and there is plenty of parking space available. The home is situated next door to the children’s services also owned by the same charity ‘Kent Kids Miles Of Smiles’. The ethos of Redwalls is to provide care for young adults who have left children’s services. The three people who currently live in the home have moved from the original service next door and already knew each other and most of the staff. Fees are in the range of £1388.89 to £2151.10. For up to date information please contact the provider. Redwalls Care Home DS0000070814.V358775.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 that people who use this service experience good quality outcomes. This is the first inspection since the service was registered on 11th October 2007. During the visit some records, policies and procedures were looked at and an accompanied tour of the premises was undertaken. Several people spoke with the Inspector including the founder of the charity, the registered manager, the house manager, carer and senior carer. One person was attending college and the two other people living in the home spoke to the Inspector. The home was clean, tidy and hygienic. The environment was warm and homely. The furnishings and décor reflected the younger age of the people who live in the home. Two people in the home showed the Inspector their rooms and spoke about their lifestyles and wishes for the future that the home is enabling them to achieve. Rapport between the founder and people who live in the home was understanding and kind and full of fun. Staff were observed communicating in an appropriate manner that was also happy and inclusive. The home embraces diversity in race and creed and the registered manager said she is currently seeking suitable training to enhance staff understanding of diversity issues. What the service does well: People who live in the home told the Inspector about the trips they had taken including, for one person, a visit to Gracelands and Nashville the previous year. Another person said he enjoys taking part in his chosen religion and community and is encouraged to attend services and regular weekly events. Staff were hugely enthusiastic about the home and the people who live there. They spoke very well about the registered manager and the organisation. The home provides many aids such as ceiling hoists, and bath and toilet aids that promote independence. The kitchen has a work surface that alters height at the touch of a button. The home has taken into account widths of wheelchairs and the ground floor is accessible to all people who live in the home. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 6 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. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People have information they need to make an informed choice about living in the home. They know they will be able to visit before making a choice about where to live. They know their individual needs are assessed. EVIDENCE: All of the people who live in the home have come from the children’s service also owned by the charity. Their assessments are from that time and the registered manager agreed to review these to make sure that Redwalls can meet their needs. Agreements from the placing agencies were seen in two care plans. The people who live there and their families were able to visit the premises prior to its being registered and whilst the home was being set up. Prospective residents will have the opportunity to visit and test-drive the home. The home has a statement of purpose and a ‘guide to your new home’ for prospective residents. The guide is clearly written and uses pictures and symbols. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 9 Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans reflect individuals assessed and changing needs. People know that they can make decisions about their lives and are supported to take risks as part of their independent lifestyle. EVIDENCE: Two care plans were looked at and these contain a lot of information that individuals brought with them from the childrens service. Although there is a lot of information, some needs reviewing and updating such as risk assessments. The Registered Manager agreed to this. There was evidence of person centred plans formats, although these were not the main recording document. The registered manager said she is currently setting up a suitable format to use for all the people living there. This will be a useful and helpful resource for staff and the people who live in the home. One member of staff is currently undertaking training for person centred planning. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 11 The registered manager is currently planning a facility to enable people to access their own information when they wish and update them as and when necessary. This will be an excellent person centred resource when it is completed. Key carers have written a detailed placement plan for each individual with helpful and specific information and advice on care and needs. Staff must remember to sign and date them. The home has not yet been open a year and the registered manager said that reviews will be held annually or more often as required. There is good written evidence of Health care professionals being involved in peoples’ emotional and physical care. Daily records are detailed. Records are maintained of spiritual and cultural needs. One person talked about his spiritual preferences and how the home encourages him to maintain contact, including regular visits, with others in that particular community. There is education information and reviews from college/training attended. Two people said they are planning on learning to drive and to get their own vehicles. The home is supporting them fully in this aspiration. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People can take part in age, peer and culturally appropriate activities including some in the community. Appropriate relationships are enabled. Peoples’ rights and responsibilities are recognised. Menus cater for preferred diets. EVIDENCE: Kent Kids Miles of Smiles is a registered charity and the charity provides funds for many activities for the people living in the home. The charity has a dedicated fundraising team for Redwalls and the adjacent service. Holidays are individual choice and one person said he had been taken to Nashville and Gracelands last year. His personal room reflected his passions and interests. Later in the day he and staff were observed speaking in a very relaxed and friendly manner that indicated staff awareness of his choices and abilities. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 13 Another person talked about his visits to friends in the community regarding his spiritual preferences. Two people attend college and one person is currently choosing a day centre for his favoured activities. The home is fully supporting this. One person said he is undertaking an IT course at college with a view to getting a job in that line of work. The home has two vehicles and several staff are named drivers. Families are made welcome and welcomed to the home, visitors are advised to telephone first to make sure people are not out at the time. Supporting relationships is taken seriously and specialist advisors are sought as appropriate. A new resident is due to move into the home in the next few weeks and already the home is arranging for suitable day centre activities that meet the assessed and preferred needs of that individual. Various activities take place outside of the home including swimming, bowling, cinemas and nightclubbing. There is a modern IT system and indoor games, music and tv facilities are available. People have the use of the hot tub next door. There are large grounds surrounding the property and plans have been made for pathways, raised vegetable plots and gardens to be constructed. All of the bedrooms have patio doors for direct access into the grounds. There are monthly social evenings. A diary of events has been planned throughout the year. Some people enjoy cooking and some housework. The purpose built kitchen has a very large work surface that can be raised or lowered at the touch of a button to suit the individual. The kitchen was clean, tidy and well organised. It has easy access for people with wheelchairs. The menu is arranged to suit the choices of people in the home and staff record meals taken. Specialist diets are catered for. The fridge and freezer were both full. One person had had a lot of fun and laughter the previous day when staff had fixed the vacuum cleaner to his wheelchair and he had wheeled himself around, cleaning as he went. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 14 The Registered Manager said that people have weekly meetings and two staff also confirmed that people will always speak out if they want something. A quarterly magazine is printed for the home. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know they will receive physical and emotional support in the way they prefer and require. Medication administration is sound. EVIDENCE: People who live in the home said that they were supported by the staff and made it clear that choices about their lifestyle were their own. Care plans contain detailed placement plans with information about preferred means of support. Daily recording and care plans record input from other agencies. Health care professionals offer physical and emotional support when requested and the local learning disability team may also be accessed. Specialist needs are carefully considered. One person spoke about his abilities and how he and the home are working together towards him gaining more independence. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 16 The home has a clear medication policy and the medication administration was clean, tidy and organised. The secure storage unit is suitable but the registered manager agreed to change the position of this to another area in the home to avoid fluctuations of temperature that may compromise the medication viability. Some administration records are to be stored securely. No controlled drugs are held. Staff confirmed that senior staff administer medication and that training is undertaken and in-house assessments are then made to make sure staff are confident to undertake this duty. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in the home know their views are listened to and acted on and that they will be protected from abuse, neglect and self-harm. EVIDENCE: The home operates a clear complaints procedure and policy that makes sure complaints will be responded to within 28 days. The Registered Manager agreed to display a simplified version of the policy and to make sure that new people living in the home receive a copy. No complaints have been received in regard to Redwalls. Staff confirmed that they understand when and how to make a complaint and that they would feel confident talking to the Registered Manager. Staff commented that they were sure residents would be able to talk to someone about any worries they may have. A member of staff said that at meetings people will ‘talk about anything continuously’ and they were quite ‘forward in expressing their views anyway’. Staff said they would also be able to pick up on any changes in behaviour and communication. Staff receive training in Adult protection. The home has an adult protection policy that includes signs of abuse to be aware of. Policies are also in place for racial harassment and bullying. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 18 Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People live in a homely, comfortable and safe environment with suitable communal spaces. People benefit from bedrooms, toilets and bathrooms that provide privacy and meet their needs. Specialist equipment maximises independence. The home is clean and hygienic. EVIDENCE: The home is a modern extension to the original house. All of the residential space is on the ground floor of the purpose built extension and the upstairs of the original house is for offices and staff facilities. The premises are spacious and planning has taken width of wheelchairs into consideration so people can access areas freely. Two people were in their bedrooms during the accompanied tour of the home and invited the Inspector to look at their rooms. These were very individual in Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 20 décor and both people said that the decoration and personal items indicated their special interests. All of the bedrooms have an en-suite toilet and washbasin. Each room has a patio door directly into the grounds. The bathrooms are designed with toilets that have a sensor to provide wash and dry facilities and baths that can be raised or lowered. This is a great boost towards independence. All rooms have discrete ceiling rails for hoists. The home is clean and hygienic. The décor reflects the younger age group and is a fresh and attractive environment. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People benefit from competent and trained staff. People are protected by the homes recruitment procedures. EVIDENCE: The staff were highly enthusiastic about working in Redwalls and with the people living there. One member of staff said she enjoyed working in the family environment. The home is recruiting for two night staff and in the meantime is managing to cover the shifts with regular staff. Employment procedures are sound, CRB (Criminal Records Bureau) checks are in place and the Registered Manager said that PoVA first (Protection of Vulnerable Adults) is used. Evidence was seen in two staff files of suitable references being received. A member of staff confirmed that she undertook induction when commencing employment and she had first worked in the childrens service next door. This meant that she already knew the people who live in the home. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 22 Regular supervision is undertaken and records were seen of this. The Registered Manager is reviewing the training matrix and some training is to be updated. Most staff has received the mandatory training and others are due to complete this. All staff has either obtained NVQ2 or 3 or will be starting a course soon. People have in the past been involved with the employment process by being invited to give their opinions of candidates. The Registered Manager confirmed that this is to continue. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People benefit from a well run home and from the management approach of the home. People know their views underpin all development of the home. People know their health safety and welfare is promoted. EVIDENCE: The home is well run and benefits from good management. The registered manager has over 18 years experience and is a registered general nurse and the NVQ 4 registered managers award. Redwalls has a clear organisational structure and includes the board of trustees, chief executive, head of care, project manager and head of fundraising. Within the home there is the registered manager, house manager and senior carers and carers. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 24 The registered manager is planning suitable questionnaires for people living in or involved with the home. A letter was shown to the Inspector from a relative that was extremely complimentary about the care given. The home has a regular assessment of competence for staff. A detailed financial policy for the year was seen. Health and safety and welfare is promoted by policies and procedures. The fire record book is maintained. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “ ” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 4 26 3 27 4 28 3 29 4 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 YA22 YA2 Good Practice Recommendations A simple complaints policy is to be on display in the home. Assessments are to be reviewed and updated where necessary. Redwalls Care Home DS0000070814.V358775.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South East Region The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Redwalls Care Home DS0000070814.V358775.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. Re-publishing this information is in breach of the terms of use of that website. 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