Inspection on 03/10/06 for David Gresham House

This inspection was carried out on 3rd October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

David Gresham House 12/01/06

David Gresham House 16/06/05

David Gresham House 01/09/04

David Gresham House 05/04/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE David Gresham House David Gresham House 226 Pollards Oak Road Hurst Green Oxted Surrey RH8 0JP Lead Inspector Damian Griffiths Unannounced Inspection 10:00 3 October 2006 rd 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 David Gresham House DS0000013622.V306467.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. David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service David Gresham House Address David Gresham House 226 Pollards Oak Road Hurst Green Oxted Surrey RH8 0JP 01883 715948 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) Abbeyfield North Downs Society Limited (The) Mrs Pamela Ann Packham Care Home 28 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (28), of places Physical disability over 65 years of age (3), Sensory Impairment over 65 years of age (3) David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The combined total of service users within categories PD(E), DE(E) and SI(E) shall not exceed six (6) 12th January 2006 Date of last inspection Brief Description of the Service: David Gresham House is a residential home for older people owned by the Abbeyfields North Downs Care Society Limited. The home, build in the 1980’s, is located in the village of Hurst Green, near Oxted. There is a small parade of shops adjacent to the home. There are outdoor areas for residents to use and there are raised flowerbeds in some areas. There is a parking area to the front of the building with additional parking on the road. The Home offers accommodation for twenty-eight residents, of which up to two places can be used for respite care. The home offers single bedroom accommodation with the majority of the rooms having en-suite facilities. There are two lounges, a conservatory, large dining room, art/therapy room, a hairdressing salon and treatment room for use by the district nurse. David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced inspection of the Commission for Social Care Inspection (CSCI) year April 2006 to 2007 using the new ‘Inspecting for Better Lives’ (IBL) process. The Registered Manager Mrs Pam Packham representing the establishment assisted regulation Inspector Damian Griffiths throughout the inspection. The IBL process involves a pre-inspection assessment of service information from a variety of sources initially helping to prioritise the order of inspections and identify areas that require more attention during the inspection process. A new Inspection record is compiled from a number of information sources received that include: A pre-inspection questionnaire completed by the home, notifications of significant events known as Regulation 37, CSCI surveys containing comments from residents and some of their representatives, comments, complaints and previous inspection reports are all considered for inclusion to the inspection record prior to the key inspection. For more details of ‘IBL’ please visit the Commission for Social Care Website details can be found on the last page this Inspection report. The inspector was with staff and residents at David Gresham House for a period of 7 hrs. This time was spent sampling resident’s care need assessments, care plans, contracts and talking to residents and staff. Staff files were inspected for evidence of good practice in the following areas: recruitment, allocation of staff skills, daily rotas and training. The specialist needs of the residents were respected at all times during the inspection. Six CSCI surveys for resident’s comments completed by service users and their representatives and the Inspector was able to talk to the mainly British residents and staff throughout the home. The inspector would like to extend thanks to the residents; staff and management at the David Gresham House care home for their assistance and hospitality. What the service does well: The home offered residents a comfortable, well-run, clean and pleasant environment. The homes Statement of Purpose promoted resident focused service and alongside the Welcome Pack’ included a wealth of information designed to inform and alert residents to activities and regulations . David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 6 The home encouraged the local community to participate meant that the management of the home was inclusive and balanced. Volunteers selected by the ‘House Committee’ were able to complete regular monthly inspections of the home. The results of each inspection were sent onto CSCI as suggested by Regulation 26 of the Care Homes Regulations. The home was supported by approximately 70 volunteers, some of which were advocates for the residents. A record of residents ‘assessed’ social and health care needs that included ,risk assessments were included in an easy to read no nonsense care needs document. Details had been clearly written and residents care needs were clear, to-the-point and easy read. Health care needs were arranged to suit the resident as far as possible and these details were also to be found and contained within the same care needs document. Residents families were supported and the residents had plenty of activities and occupation. Quarterly meetings were held for residents to discuss issues important to them and for information exchange and details of staff and residents birthdays were to be found in the ‘Welcome Pack’ given to all residents. Medicines were safely stored in an excellent purpose built room allowing staff plenty of space to plan and organise residents prescribed medication needs. Residents felt confident to make complaints and the home was able to respond well and staffs were aware of adult safeguarding issues to reduce the possibility of abuse. Residents completing the CSCI Survey stated that they knew who to talk to if they were unhappy. 50 of staff had attained level 2 of the National Vocational Qualification (NVQ). The home had recently conducted it’s own quality assurance exercise seeking residents views on a number of relevant issues concerning the quality of its service and care. Fabulous, very satisfied and very pleasant were a few of the comments received. The home has an excellent relationship with the local community and there were plenty of people ready to volunteer and assist residents and staff, consequently there were no problems for residents who wished to get out ‘for a pint’, go to church or other events. The ‘Ethos’ or culture of this home was excellent . What has improved since the last inspection? Care plans for all service users were kept up to date and complete. David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 7 A detail of the homes prevention of adult abuse policy was in place and fully updated since June of this year. 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. David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 8 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 David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents on short stays or ‘respite’ were fully informed about the home and had received an assessment of their care needs. Intermediate care is not available at this home. EVIDENCE: New residents to the home receive a Statement of Purpose and a ‘Welcome Pack’ containing full and comprehensive information. Two residents staying at the home on respite care stated that they had received ‘satisfactory’ amount of information about the home, including details of the management structure, manager and staff qualifications, fees, daily routines and much more. Five residents care plan documents were sampled including new residents, residents staying for respite care and a resident with a sensory impairment. The assessment documents contained complete records of the residents care needs, contracts if self funded and care plans formulated from a comprehensive assessment of social and health care needs. David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 10 New residents receive an initial assessment prior to being offered a place at the home and were subject to further assessment over a six-week period. Every effort was taken to establish whether the home could meet the need of a possible new resident. The resident would be offered time at the home to experience the routines and meet other residents, day visits or short-term stays were available. It was recommended that the residents place of birth be featured in the next reprint of the care needs document. This was currently being written in by hand. Please see the recommendations section of this report. David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8.9, 10 and 11. Quality in this outcome area is excellent this judgement has been made using available evidence including a visit to this service. Residents enjoyed an excellent level of care due to the commitment of staff and accurate records of care assessment, documentation and awareness that ensured that care was provided in a sensitive and respectful manner. EVIDENCE: The care plan document was easy to manage containing all the necessary details required for the staff to deliver care in an informed and personalised way. The care plan document included, assessments of personal, social and health care need and risk that had been compiled by residents and staff. This informe staff of what help was required, such as: supervision with bathing or whether the resident used a cane’ and would required help to stand. This document was kept in the managers’ office and was available to the appropriate staff members. Residents stated that they did not relish the review process however; the care plans sampled had been regularly reviewed, as were other sections. Each David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 12 section of the documentation had been signed by residents their, key worker and the manager. Full details of health care needs were available recording the various needs of the resident, such as: regular monitoring; for diet, weight and blood tests results. Residents’ ability to take their own medication had been risk assessed and resident signed and agreement with the home to state whether or not they wished to have help ,as self-reliance was encouraged. Medication was properly monitored and administered. Incident forms were in evidence recording any change of medicinal need, accident or missed medication. Medical Administration Records (MAR) were observed being used in a proper manner with details of the administrator being written against the dosage given to each resident. All details on the ‘MAR’ matched the prescribed medication that was distributed by trolley. Drug returns and controlled drugs books were all in order. The home has an separate and secure room designed to house all medication. It was recommended that The Pharmacist to the home stamp the drugs returns book as well as signing it as practiced. A resident who was having difficulty with continence needs praised staff for their sensitivity and practical help. Staff reassured the resident and his family and ensured they were confident and happy to manage these issues when going out as a family. The inspector was privileged to meet the relatives of a resident who had recently passed away. They said that: ‘they could not fault the care we received during the last hours of Mothers life’. Please see the recommendations section of this report. David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were able to enjoy the local community facilities regular religious services and social activities. The residents received regular choice of food and could request alternative meals from the menu provided. EVIDENCE: The home is situated very close to the local shops and residents consulted all felt they had plenty of opportunity to access theses service. Male residents who enjoyed a drink in the local pub could do this relatively easily due to the strong support received by volunteers at the home. Access to church services and attendance to the spiritual needs of the residents was available every week. Residents agreed that they were always able to make their own choices and were supported with by staff. Areas discussed were self medication and money management. The inspector was able to join the residents at lunchtime and was able to observe the quality of the food and resident’s responses. A comment from residents about the meals was very good; the chef consulted the residents on a daily basis asking them what they would like from the set menus provided. Residents confirmed that they could alter the menu to suit their own taste. David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 14 Food was nutritious and the menu contained a variety of dishes complimented with fresh vegetables low fat deserts and fruit. The chef had made special ‘taster dishes’ for residents to try different and new food combinations and products. David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 15 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints were managed in a positive way and safeguarding of vulnerable adults procedures and policies were available. EVIDENCE: The pre-inspection questionnaire provided by the home recorded five complaints had been made each complaint had been resolved and one had been partially substantiated. A resident completing the CSCI Survey requested a meeting with the inspector. The resident was pleased with the ‘well-run-home’ and with care arrangements in place. A minor concern about who the director of the home was and how to obtain the annual directors report. It was evident however that full details of those responsible were on full display on the wall at the entrance of the home and details present in the Statement of Purpose. Photographs identified the management committee and advocates and illustrated the management structure. Full details of the complaints policy and practice could be found in the Statement of Purpose including contact details for CSCI and the Independent Housing Ombudsman. It is recommended that the home discuss this area of home management at the next residents meeting. David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 16 There were no incidents or allegations of abuse reported to CSCI or the inspector since that last inspection. A detail of the homes prevention of adult abuse policy was in place and had been updated in June of this year. The Criminal Records Bureaux (CRB) checked all volunteers. David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. David Gresham House provided a secure, relaxed and homely environment for its residents. EVIDENCE: A tour of the premises was conducted immediately and the inspector was able to circumvent the premises and talk to residents inside and outside of the home prior to announcing the inspection. The grounds and gardens were clean, well maintained and secure. CCTV was situated appropriately throughout home in places that would not compromise the dignity or privacy of the residents. Gardens contained planting that was sympathetic to the sensory needs of residents containing rose and lavender beds. The entrance to the home was clean, tidy and welcoming and staff were available to help the visitor. The home was bright and airy throughout and residents’ rooms were clean and tidy due to the excellent work of the homes cleaning staff. Bedrooms reflected the individuality of the resident: David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 18 ornaments, photographs and pictures of special significance were on display and respected by staff. Each floor had its own laundry facilities that were clean, tidy, airy and secure following COSHH requirements. All areas of the home were in good condition and consistently well maintained. David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoyed the benefits of receiving care from a well qualified and supportive staff team who had been selected by merit and recommendation derived from a robust recruitment process. EVIDENCE: The duty rota for the day was inspected and the files of the staff present were sampled to establish whether they had received adequate training to meet the needs of the service users and to ensure that staffing levels were adequate. Training was available to all staff as confirmed by cleaning and care support staff. Training received by the staff on duty included: food hygiene, coshh, basic life support, first aid (30 of all staff) and fire safety. Staff employed on night duty had received a good standard of training including: safe manual handling, fire procedures refresher, medication, protection of vulnerable adult and diabetes care. New staff received good induction training and the pre-inspection questionnaire completed by the home confirmed that 50 of staff had attained level 2 of the National Vocational Qualification therefore meeting the National Minimum Standards . David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 20 Staff files were checked for evidence of good recruitment practice. All documentation was in good order showing that files contained evidence that a criminal record checks (CRB) had been completed, written references and employment history, terms and conditions history and work time regulations. David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33, 35 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Management style at the home was all-inclusive and residents benefited from the homes commitment to provide a resident focused service that encouraged community involvement and promoted health and safety. EVIDENCE: The registered manager operated an open door policy for all. Staff were supportive and caring and enjoyed an excellent level of support from staff and the local community. A seventy strong volunteer force was complimented the staff team and were valued for the joint work and play that could be achieved through this partnership. The house committee consists of volunteers who provide a high level of hands on support, and unusually, this included the responsibility for ‘Regulation 26 reports’ that are monthly inspections of the home that include attention to: residents general health and wellbeing , standards of cleaning, decoration, staffing and activities , the completed document being sent regularly to CSCI. David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 22 The home had recently conducted it’s own quality assurance review seeking residents views on a number of relevant issues concerning the quality of its service and the quarterly house meetings ensured residents a regula platform to express their views. ‘Fabulous’, ‘very satisfied’ and ‘very pleasant’ were a sample of the comments received. There was also a good selection of CSCI comment cards with prepaid envelopes available for residents, friends’ and relatives convenience and situated in the entrance hall. Residents and their relatives manage their own money and the home only gets involved if residents ask to sue the homes safe. Only small amounts of money, no more than £50, are stored for short periods of time. A receipt book recording all transactions of resident’s money is used. There were no health and safety concerns: fire drills and extinguishers were in place and fire safety training, health and safety, food hygiene and safe handling training had been received by staff. This was a very positive inspection. David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 23 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 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 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 4 4 3 X 3 X X 3 David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 24 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. 3. Refer to Standard OP1 OP9 OP16 Good Practice Recommendations It was recommended that the residents place of birth ,currently being written in by hand, be featured in the next reprint of the care needs document. It was recommended that the Pharmacist to the home stamp the drugs returns book as well as signing it, as currently practiced. It was recommended that the home ensure that the management structure and annual chairman’s report is available for discussion at the next residents meeting. David Gresham House DS0000013622.V306467.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 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 David Gresham House DS0000013622.V306467.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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