Care Home: The Red House Residential Carehome

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What the care home does well The staff at The Red House are caring and many have worked at the home for a number of years. Staff are experienced and have the required skills to support people in the home. Staff we spoke with on the day of our visit demonstrated to us that they had a clear understanding of their role and responsibility. The Registered Manger Roy Orme has been in post at the home for a number of years and the Commission have previously received no concerns about his management ability. Records relating to the care, emotional and health care requirements of individuals are well written and sufficiently detailed, records are kept under review and are updated when needed. We saw evidence to show us that usually the home is well maintained and when action is needed to rectify a problem this is responded to promptly by the Registered Provider. The people we spoke with who live at the home told us that they were happy there, that staff were lovely and they had many friends within the home. One lady took us to her room which was comfortable. We saw that people living at the home were relaxed and appeared to be settled and happy. What the care home could do better: There are a number of areas which must be addressed by the Registered Provider and the Registered Manager to ensure that those living at the home are safe and are supported appropriately. The Registered Provider must ensure that at all times there are appropriate staffing levels in place and also, were possible, that people living at the home are supported with their personal care by staff of the same gender. This is to ensure that people are supported in line with their assessed needs and their personal preferences. The Registered Manager and the Registered Provider must ensure that practices and routines within the home are tailored around the expressed wishes and choices of people living at The Red House and that the service is not led by the needs of the staff. The Registered Provider and the Registered Manager must ensure that all staff adhere to the risk assessments and the policies and procedures which are in place to both support and protect people from danger and harm. Furthermore when incidents occur at the home which affect the wellbeing of individuals who live there the Registered Manager must ensure that The Commission and the placing authority are notified promptly and in a timely manner. In order that those living and working at the home can be confident in the managers ability to lead and direct the service in line with the aims and objectives of the service. And also that the home is run as it is outlined within the homes statement of purpose it is required that the manger undertake refresher training in both protection of vulnerable adults training and first aid. Furthermore the Registered Provider must act upon the outcomes of the safeguarding strategy meeting findings and must demonstrate to us how he will monitor the fitness of the manager, this must be confirmed to us in writing. To further ensure that effective systems are in place to ensure that those living at the home are safe it is recommended that the home review the current procedure for the checking and recording of hot water temperatures and consideration should be given to this responsibility being delegated to others. To protect people from slipping in the bath and shower areas it is also recommended that a slip mat is obtained for these areas. To demonstrate that staff are respectful to those who live at the home and are aware of their responsibility and accountability action must be taken to ensure that staff use appropriate non judgmental statements when writing in individuals records. Inspecting for better lives Random inspection report Care homes for adults (18-65 years) Name: Address: The Red House Residential Carehome 5 Conygre Road Filton South Glos BS34 7DA The quality rating for this care home is: The rating was made on: 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Odette Coveney Date: 0 8 1 0 2 0 0 8 Information about the care home Name of care home: Address: The Red House Residential Carehome 5 Conygre Road Filton South Glos BS34 7DA 01179693053 Telephone number: Fax number: Email address: Provider web address: royorme@yahoo.com Name of registered provider(s): Type of registration: Number of places registered: Mr Heron Moodie care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability 10 Over 65 0 Conditions of registration: The registered person may provide the following category of service only: Care home providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability- Code LD The maximum number of service users who can be accommodated is 10. Date of last inspection Brief description of the care home The Red House is registered as a private care home, and provides accommodation for eight adults with learning disabilities. The range of fees start from 518.00 per week up to 627.00. The home is located in the South Gloucestershire region in the residential area of Filton. The home was successful in 2007 when applying for a major variation in order to increase the homes numbers from 8 to 10 to accommodate two residents who can be accomodated in the house next door. There is currently one person in this house. The Red House is near to the main arterial road leading north from Bristol, which connects the main M4 and M5 motorways. It is close to a range of shops, a post Care Homes for Adults (18-65 years) Page 2 of 12 office, library, pubs and Filton College. There is a GP surgery and Optician within close walking distance. It is close to the bus routes that go into Bristol, a journey of approximately three miles. The Red House is a large, mature, detached Victorian twostorey building of red brick construction, the house name was chosen by the original group of residents. There are two large communal areas, two single bedrooms and a staff room on the ground floor, with six single rooms on the first floor. Each bedroom has a vanity unit to provide en-suite washing facilities. There are gardens surrounding the house, with a range of mature trees, shrubs, a pond, and flower and vegetable beds. The garden is fully wheelchair accessible, and there is also a greenhouse and a summerhouse, which are widely used, in the warmer months. The laundry facilities are sited away from the main house in the garage. A wide range of leisure activities are available for residents, and the home has a large display of photographs which record activities and significant events. The home has a car for use for those who live at the home for outings and holidays. Care Homes for Adults (18-65 years) Page 3 of 12 What we found: This visit was unannounced. This random site visit was undertaken by one inspector we arrived at the home at 8:00 am and we were at the home for four hours. This random visit was conducted as a direct result of a safeguarding alert which had been raised to South Gloucestershire Community Care and Housing Department by a relative of an individual who lives at the home. During this time there have been three safeguarding strategy meetings held which have involved a number of professionals including ourselves and representatives from both health and social services. The outcomes of the investigation were shared with both the Registered Provider and the manager of The Red House on October 21st. The findings will also be shared with the relative who raised the alert and other involved parties. The purpose of this visit was to review the care for one person at the home who had recently been injured following an incident at the home. A number of documents associated with the care of this individual were reviewed. We also reviewed a number of other documents in relation to the incident. We viewed risk assessments, policies and procedures in respect of bathing and showering. We reviewed the staffing levels, talked with staff on duty and reviewed duty rotas and read minutes of team meetings. We also reviewed records related to health and safety at the home, these included the records of hot water temperatures, maintenance and repair records and contractors service visits. As previously stated during this site visit we focused on the care and associated documents for one individual, we also sampled the records for one other person. We reviewed the individuals care plan to review how they are supported at the home with their personal care and to review the risk assessments in place to support this person with their independence at the home. We saw that this persons care plan had been generated from a care management assessment of the individuals needs, prior to their admission into the home. We saw that the home had developed the individuals care plan based on their assessed needs and had recorded how the person would be supported within many aspects of their life such as personal and emotional, physical and health care support. We saw that the plan set out the individuals personal goals, wishes and views. We saw that the home kept this individuals care plan under review and it had been updated when required. We saw within the care plan that staff had respected and recorded the decisions made by the individual and that the home provide information, assistance and communication support needed in order that the person can make decisions about their life. We reviewed risk assessments for this individual and saw that risks are well recorded and sufficiently detailed in order to direct and guide practice. We saw that the home had assessments of how individuals should be supported with their personal care, with the use of the bath and shower. We also saw that the home had clear health and safety policies to protect both those who live and work at the home. We paid particular Care Homes for Adults (18-65 years) Page 4 of 12 attention to the bathing and showing risk assessments and saw that the manager had updated the the risk assessments following the incident. If the risk assessment in place now had been followed then the incident may have been avoided. We reviewed the daily records, this is where staff record what individuals have done during the day, how they have spent their time and how they have been supported at the home. We were concerned to see that staff had used inappropriate and offensive language when describing people, this is not acceptable. The Registered Manager must ensure that staff are respectful at all times and must demonstrate that staff are non judgmental in their manner, approach and report writing. When reviewing the incident which had been reported to us there was some confusion about how many people had been supported with their personal care. The manager told us that three people had been assisted or encouraged to wash or bathe before six pm that evening. We spoke with two members of staff who were on duty when we arrived. They told us that this would not be normal practice and that usually at this time in the early evening the people who live at the home would be having their tea. The manager told us that on this evening the ladies within the house had requested a pampering session and that the night in question was an exceptional occasion for early personal care support and was not normal practice within the home. We also questioned why the male manager was supporting females with their personal care. Whilst we accept this happens on occasion, the home should, where possible, ensure that both genders of staff are on duty to support people with this intimate area of their care. Furthermore the home must ensure that practice and routines in the home are reflective of individuals personal choice and wishes, practices at the home must be tailored to the needs of the individual and not centered around the needs of the service. We checked the bathroom where the incident occurred and checked the water temperature in this area, this was at a safe level. We saw a notice which appeared to have been up for some time reminding staff of what the water temperatures should be to be safe for residents use and saw a thermometer in place. This thermometer was in good working order. We saw that the bath is relatively deep and although there were handrails on either side of the bath there was not slip mat in place, it is recommended that these mats be in place at all times in bath and shower areas to prevent people from slipping. We reviewed the record maintained at the home of hot water temperatures. We saw that four different areas are checked on a monthly basis, one week the kitchen water temperature is checked, another time the upstairs bath water. The records showed that it was always the manager who undertook this check and records showed that on no occasion did the water temperature exceed the required safe temperature. We recommend that the home review the procedure for the checking of the hot water temperatures and consideration should be given to other staff completing this task. This would share the responsibility for this. Staff should also be reminded of their responsibility to report incidents to others if they feel appropriate action has not be taken by the home to ensure the health, safety and welfare of those living at the home. We spoke with the staff on duty. Both staff members are experienced in this field of Care Homes for Adults (18-65 years) Page 5 of 12 work and have worked at The Red House for a number of years. Both staff members were fully aware of their role and responsibilities and were able to demonstrate a sound understanding of the needs of individuals who live at the home. They told us about individuals preferred support and how they encourage people to make decisions about their life. Both staff members were conversant with the protection of vulnerable policies and of the reporting procedures. Both staff were extremely knowledgeable about the support needs of individuals living at the home and told us of individuals preferred lifestyle and gave examples of how individuals are encouraged to make choices about their life. We found that a combination of events contributed to the serious incident in which a person who lives at the home was injured. The incident could have been avoided and actions must be taken by the home to ensure that this never happens again. At this visit we reviewed a requirement made when we last visited the home in December 2007, this was that attention must to be given to the ground floor bathroom and the ceiling to be painted in this are and furthermore that window frames and seals to be given attention, this requirement had been met. What the care home does well: What they could do better: There are a number of areas which must be addressed by the Registered Provider and the Registered Manager to ensure that those living at the home are safe and are supported appropriately. The Registered Provider must ensure that at all times there are appropriate staffing levels in place and also, were possible, that people living at the home are supported with their personal care by staff of the same gender. This is to ensure that people are Care Homes for Adults (18-65 years) Page 6 of 12 supported in line with their assessed needs and their personal preferences. The Registered Manager and the Registered Provider must ensure that practices and routines within the home are tailored around the expressed wishes and choices of people living at The Red House and that the service is not led by the needs of the staff. The Registered Provider and the Registered Manager must ensure that all staff adhere to the risk assessments and the policies and procedures which are in place to both support and protect people from danger and harm. Furthermore when incidents occur at the home which affect the wellbeing of individuals who live there the Registered Manager must ensure that The Commission and the placing authority are notified promptly and in a timely manner. In order that those living and working at the home can be confident in the managers ability to lead and direct the service in line with the aims and objectives of the service. And also that the home is run as it is outlined within the homes statement of purpose it is required that the manger undertake refresher training in both protection of vulnerable adults training and first aid. Furthermore the Registered Provider must act upon the outcomes of the safeguarding strategy meeting findings and must demonstrate to us how he will monitor the fitness of the manager, this must be confirmed to us in writing. To further ensure that effective systems are in place to ensure that those living at the home are safe it is recommended that the home review the current procedure for the checking and recording of hot water temperatures and consideration should be given to this responsibility being delegated to others. To protect people from slipping in the bath and shower areas it is also recommended that a slip mat is obtained for these areas. To demonstrate that staff are respectful to those who live at the home and are aware of their responsibility and accountability action must be taken to ensure that staff use appropriate non judgmental statements when writing in individuals records. 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 2. Care Homes for Adults (18-65 years) Page 7 of 12 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 8 of 12 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 16 12 The Registered Provider must 08/12/2008 ensure that the home is conducted in such a way as to ensure that practices and routines are tailored around individuals needs and not the needs of the service. This would ensure that individuals wishes and personal preferences are respected and adhered to. 2 37 18 The Registered Person must 06/12/2008 make sure that at all times their are suitably qualified and competent staff working at the home This is to ensure that at all times there are appropriate numbers of staff on duty at all times to support people living at The Red House 3 37 18 The Registered Provider must 06/12/2008 act upon the outcomes of the safeguarding strategy meetings and put their proposed actions to us in writing. This is to demonstrate that Care Homes for Adults (18-65 years) Page 9 of 12 the Registered Provider is monitoring the fitness of the manager and to ensure that he is confident in the managers ability to run the service effectively and in the best interests of those who live at The Red House 4 37 18 The Registered Person must 24/12/2008 make sure that at all times their are suitably qualified and competent staff working at the home. The Registered Manager must undertake refresher training in protection of vulnerable adults and first aid. This is to ensure that he has the skills and knowledge to act appropriately in emergency and situation where people are at risk. 5 42 37 The Registered Provider must 06/12/2008 ensure that incidents which affect the wellbeing of individuals living at the home are reported to The Commission and the placing authority in a timely manner. This is to demonstrate that incidents have been dealt with effectively and also in order that we may monitor activity at the home and the outcomes for people living at The Red House 6 42 13 The Registered Provider must 06/12/2008 ensure that the policies, procedures and risk assessments in place are adhered to. This is to ensure that those living at the home are protected from harm and to ensure that staff practice is in line with the expectations Care Homes for Adults (18-65 years) Page 10 of 12 of their role and responsibilities. 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 1 6 Staff should be reminded of their responsibility and accountability when writing judgmental statements in individuals records. The home should ensure, wherever possible, that people are supported with their personal care by a person of the same gender. A slip mat should be provided to the bath and shower reas in order to reduce the likihood of people slipping. The procedure for the recording of hot water temperatures should be reviewed. 2 18 3 4 42 42 Care Homes for Adults (18-65 years) Page 11 of 12 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 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. 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