Care Home: The Red House

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What the care home does well There are good systems to assess people`s needs before they move into the home. This helps to assure people that the home will be able to meet their needs. People`s health and personal care needs are well met and staff treat people in a manner that maintains their privacy and dignity. There is a very good care planning system, which focuses on people`s specific needs and how staff should meet them. People`s social and cultural needs are very well met by the home and people are supported to make choices. This helps people to retain as much control over their lives as possible. The home has good systems to investigate complaints and respond to allegations of abuse. This gives people confidence that any complaints will be taken seriously and responded to. The home is well maintained and provides a homely, comfortable and safe environment for people. Staff are well trained, deployed in sufficient numbers and thoroughly checked before they work in the home. This helps to protect people and ensure the home can meet their needs. There are good management and quality assurance systems, which helps to ensure the home is safe and run in the best interests of people who live there. What has improved since the last inspection? Each person now has a fire evacuation risk assessment. This will help to ensure people receive the right support if there is a fire in the home. People`s money is no longer paid into the home`s business account. This gives people more control over their money. A full employment history of staff is now obtained before they work in the home. This helps to ensure that staff have the right experience and skills to meet people`s needs. What the care home could do better: The manager has a plan of improvements she has identified and should ensure that these are implemented. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Red House 2 Southampton Road Fareham Hampshire PO16 7DY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Craig Willis     Date: 2 0 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: The Red House 2 Southampton Road Fareham Hampshire PO16 7DY 01329287899 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr C G Watts,Mrs E Watts care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: All services users must be at least 55 years of age. Dispensation has been given in order that one named service user (09/08/1953) could be admitted under the age of 55. No more than 7 service users in total can be accommodated in the categories DE, MD and PD Date of last inspection Brief description of the care home The Red House is a care home providing personal care and accommodation for 36 people, including those with dementia. The home is located in the town of Fareham and is close to local amenities. Mr and Mrs Watts bought the home in 1987. The home consists of a two storey Victorian house that has been extended. All the bedrooms are single, and eighteen bedrooms have en-suite toilet facilities. Communal facilities Care Homes for Older People Page 4 of 24 7 7 0 7 Over 65 36 36 36 10 Brief description of the care home include a sun lounge, conservatory lounge, dining room, dining/activities room and a room for smokers. The current weekly fees range between 415 abd 475 pounds, depending on the room occupied. Additional charges are made for hairdressing, chiropody, newspapers, personal toiletries, transport, outings and dry cleaners. 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: The evidence used to write this report was gained from a review of all the information we have received about the service since the last inspection and a visit to the home. The information included an annual quality assurance assessment completed by the manager, incident reports and surveys from people who live in the home, staff and health professionals. A site visit was carried out on 20 January 2009 and lasted approximately seven hours. During the visit we spoke with people who live in the home, staff members on duty and the manager. Documents relating to the running of the home were inspected and the homes communal areas were viewed. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 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 8 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. There are good systems to assess peoples needs before they move into the home. This helps to assure people that the home will be able to meet their needs. Evidence: The manager reported in the annual quality assurance assessment that people only move into the home following a comprehensive needs assessment and that people are provided with clear information about the services the home offers. During the visit we inspected the records of four people who live in the home. All four people had a comprehensive needs assessment that was completed before they moved into the home. The assessments included peoples mobility and physical needs, personal care needs, communication, nutrition, social and cultural needs, mental health, medication and any risks the person faces. Copies of peoples care management assessment were also available for those funded through adult services. Staff spoken with reported they were confident that the information they receive about peoples needs is accurate. Care Homes for Older People Page 9 of 24 Evidence: Thirteen people who live in the home completed a survey for us. Twelve said they received enough information about the home before they moved in so they could decide if it was the right place for them. The person who said they did not receive enough information did not say what else they needed. Care Homes for Older People Page 10 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. Peoples health and personal care needs are well met and staff treat people in a manner that maintains their privacy and dignity. There is a very good care planning system, which focuses on peoples specific needs and how staff should meet them. Evidence: The manager reported that each person has a comprehensive care plan that is developed with them and their representatives and regularly reviewed. We inspected four peoples care plans during the visit. Each person had a plan in place that had been reviewed each month and amended where peoples needs have changed. The plans set out how staff should meet peoples specific needs and also contained assessments of any risks that people face. There was a risk management plan for each person that set out how the risks to the person should be managed to an acceptable level. Following the last inspection we made a requirement that a fire evacuation risk assessment must be completed for each person. Each record inspected has an individual fire evacuation assessment, setting out the specific needs of the person in relation to fire safety and evacuating the building. This requirement has been met. Staff support each person to Care Homes for Older People Page 11 of 24 Evidence: complete a life profile. These provide detailed information about peoples different experiences and culture and enable staff to tailor the care provided to peoples individual needs and wishes. People are registered with a local GP and supported to attend the health services they need. Records are kept of appointments, including any advice given by the practitioner. We received completed surveys from a consultant psychiatrist and community matron who provide services to people living in the home. Both said the home always seeks advice and acts on it to manage and improve peoples health care needs. The community matron reported that some training issues for specific staff have been identified regarding meeting health needs, but went on to say, as soon as problems are identified the senior carers and managers act swiftly to attend to individuals health care needs. Thirteen people who live in the home completed a survey for us. Twelve said they always receive the medical support they need. One said they usually receive the medical support they need, but did not give any information about when this had not happened. The home has medication procedures in place, although these were not inspected during the visit. Medication is stored in locked cupboards, a medication fridge and trolleys in the care office. The medication administration records for the current month were inspected and had been fully completed. This gives a record of all medication brought into the home and when it was administered to people. A record of medication returned to the pharmacy for disposal was also available. Staff administering medication have received assessed training, which is regularly reviewed to ensure their skills are kept up to date. One of the homes deputy managers takes lead responsibility for the medication system. People spoken with during the visit reported that staff treated them well and maintained their privacy and dignity. Thirteen people who live in the home completed a survey for us. All said they receive the care and support they need and staff listen to them and act on what they say. Staff were observed interacting with people in a firendly and respectful manner during the visit. Care Homes for Older People Page 12 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples social and cultural needs are very well met by the home and people are supported to make choices. This helps people to retain as much control over their lives as possible. Evidence: The home gathers information about peoples individual wishes and preferences and uses them to plan a programme of activities. Examples of group activities included visiting entertainers and musicians, exercise, bingo, crafts, cooking, gardening, reminiscence, a film club, tea dance and sensory music sessions. Peoples specific needs are taken into account and where people are not able or do not want to join in group activities, one to one activities are planned with them. The home has an activities co-ordinator who works with people individually to ensure their social and cultural needs are being met. Thirteen people who live in the home completed a survey for us. Seven said there were always activities arranged by the home that they can take part in and six said there usually were. People spoken with said they like the activities that are organised and are able to decide whether to take part in them or not. A record is kept of what activities and interactions each person has taken part in. The home has a open visiting policy and visitors are welcome at any time. People Care Homes for Older People Page 13 of 24 Evidence: spoken with reported that their visitors were always made welcome in the home by the staff. People spoken with during the visit confirmed that they were able to make choices about how they spent their time. Staff spoken with demonstrated a good understanding of peoples needs and the importance of supporting people to make decisions where possible. All thirteen people who live in the home that completed a survey for us said staff listen to them and act on what they say. One person added, the staff are very friendly and easy to talk to. During the visit staff were observed interacting with people in a friendly and respectful manner and responding promptly to requests for assistance. The home has a four week planned menu that offers a choice of two main meals and is changed seasonally. People spoken with reported that the food was good and confirmed that they could make a choice from the menu or request something different. Peoples specific dietary needs and their likes and dislikes are recorded and taken into account with the menu planning. During the visit a mealtime was observed. There was a choice of two dining areas and staff were providing support to people where necessary. The atmosphere was relaxed and the meal was clearly seen as a social occasion by people who live in the home. Thirteen people who live in the home completed a survey for us. Eight said they always like the meals in the home and five said they usually like them. One person added, There is a always a varied menu with a choice if there is something I dont like. There are always fresh vegetables every day. Care Homes for Older People Page 14 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. The home has good systems to investigate complaints and respond to allegations of abuse. This gives people confidence that any complaints will be taken seriously and responded to. Evidence: The home has received one complaint in that last year, concerning an allegation of theft and lack of care. The manager reported the issues to the police, adult services and us. No evidence was found to substantiate the complaint. We received one complaint from a former service user about their treatment at the home, which was referred to adult services under the safeguarding procedures. There was no evidence to substantiate this complaint. The home had records available of the complaints and action taken. There is a complaints procedure, which is supplied to everyone who lives in the home. Thirteen people who live in the home completed a survey for us; twelve said they know how to make a complaint. People spoken with during the visit said they know how to make a complaint and were confident that any complaint would be taken seriously and investigated. Staff have received training in keeping people safe from abuse and the reporting procedures. Staff spoken with demonstrated a good understanding of different types of abuse and action to taken if abuse is reported, witnessed or suspected. Following the last inspection we made a requirement that one residents money must Care Homes for Older People Page 15 of 24 Evidence: not be paid into the homes business bank account. The manager has supported this person to open their own bank account, which they operate independently. This requirement has been met. 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. The home is well maintained and provides a homely, comfortable and safe environment for people. Evidence: All of the communal areas of the home and a sample of the bedrooms were viewed during the visit. All areas were clean and well decorated, with no unpleasant odours. The home has three lounge areas, two dining areas and a smoking room. The lounge areas had a choice of entertainment during the visit, one with the television, one with music and one that was quiet. Bathrooms are fitted with suitable equipment to support people with mobility difficulties. All of the bedrooms seen were comfortably furnished and clean and people had personalised them with pictures, ornaments and small items of furniture. There is an on-going programme of decorations and people have been consulted about the redecoration of their bedrooms. Staff reported that maintenence issues are resolved quickly. Thirteen people who live in the home completed a survey for us; all said the home was always fresh and clean. The home has a sepeate laundry room, which is clean and well maintained. The machines are capable of washing soiled clothing and there are suitable infection control procedures in place. 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. Staff are well trained, deployed in sufficient numbers and thoroughly checked before they work in the home. This helps to protect people and ensure the home can meet their needs. Evidence: Between 8am and 2pm the home has four care staff and at least one deputy manager; between 2pm and 8pm there are three care staff and at least one deputy manager; overnight there are two care staff awake and one person asleep and on-call to help out with emergencies. In addition there are cleaners, kitchen and maintenence staff and the home manager. Thirteen people who live in the home completed a survey for us; ten said there were always staff available when they need them and three said there were ususally staff available. One person added, I find there is always a member of staff day and night on hand if I need them. Five staff members completed a survey for us; four said there were always enough staff to meet the individual needs of people who use the service and one said there usually was. Following the last inspection we made a requirement that the manager must obtain a full employment history of people, including any gaps in employment, before they start work in the home. We inspected the records of two recently recruited members of staff during the visit. Both has a full employment history, confirmation that a criminal records bureau disclosure had been obtained about them, two written references and Care Homes for Older People Page 18 of 24 Evidence: confirmation of the persons identity. This requirement has been met. New staff complete an induction based on the skills for care common induction standards and 58 of the staff have completed the National Vocational Qualification in care at level 2 or above. The home has an on-going training programme for staff, with courses including care planning, adult protection, communication, medication, fire safety, food hygiene, moving and handling, dementia, infection control, first aid and continence care. Staff spoken with said they received good training which helped them meet peoples needs. All five staff who completed a survey for us said they receive training that is relevant to their role, helps them understand and meet peoples needs and keeps them up to date with new ways of working. 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. There are good management and quality assurance systems, which help to ensure the home is safe and run in the best interests of people who live there. Evidence: The manager is registered as the provider of the service, along with her husband who also works in the home on a daily basis. The manager has 36 years experience of working with older people and has completed the registered managers award. The manager reported she undertakes regular training to keep her skills and knowledge up to date. Staff spoken with reported they receive good support fom the manager. The home has a quality assurance system in place to assess how they are performing and plan improvements. The manager completed a very detailed quality assurance assessment for us, setting out areas where she feels the service could be improved and how they are going to make the improvements. An annual survey is completed of people who live in the home, relatives and health professionals. The results of the surveys are collated and presented on the homes noticeboard. The collated results are Care Homes for Older People Page 20 of 24 Evidence: used to develop a plan of improvements. An outside company is used to complete health and safety audits and the home has achieved the investors in people award. The home does not operate any bank accounts for people but does hold money for safekeeping where people have asked them. The money of two people was checked and the records were found to match the cash held. Money is stored in a safe and records are kept of expenditure, including receipts. The servicing records for the fire alarm and extinguishers, lifts, hoists and gas system were checked and demonstrated equipment is being suitably serviced and checked to ensure it is safe. 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 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: 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 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) Commission for Social Care Inspection (CSCI). 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 CSCI 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. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!