CARE HOMES FOR OLDER PEOPLE
Ealing House Residential Home 86 Repps Road Martham Great Yarmouth NR29 4QZ Lead Inspector
Hilary Shephard Unannounced 16 June 2005 09:45 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 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. Ealing House Residential Home I55 s33998 ealinghouse v233489 160605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Ealing House Residential Home Address 86 Repps Road, Martham, Great Yarmouth, Norfolk, NR29 4QZ 01493 740227 01493 740227 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Sally Watson Mrs Sally Watson Care Home 10 Category(ies) of Dementia (10), registration, with number Old age, not falling within any other category of places (10) Ealing House Residential Home I55 s33998 ealinghouse v233489 160605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 24th November 2004 Brief Description of the Service: Ealing House is a care home providing personal care and accommodation for 10 older people with dementia. It is owned and managed by Mrs Sally Watson. The home is located in the centre of the village of Martham close to shops, pub and local amenities. The home has been open for thirty years and consists of a detached two-storey house. The bedrooms comprise of four single and three shared rooms, with a variety of communal space. The building is situated within its own grounds, with an enclosed garden at the rear. Ealing House Residential Home I55 s33998 ealinghouse v233489 160605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over 3 ½ hours and during the inspection, all residents and staff were spoken with. What the service does well: What has improved since the last inspection?
Care plans have improved, and are more focussed on individual residents needs, and have been completed in a format providing clear detail and guidelines for staff to follow. Some improvements have taken place to the environment, two residents benefit from their bedroom having a new carpet, and all benefit from a refurbished bathroom. Infection control practices have improved with the addition of antibacterial hand rub for staff to use, ensuring the risks of cross-infection are minimised. Temperature control valves have been fitted to hot taps, and windows now have restrictors, providing a safer environment for the residents. In order to provide more topics for discussion and stimulation, more items nostalgic of residents past have been introduced.
Ealing House Residential Home I55 s33998 ealinghouse v233489 160605 Stage 4.doc Version 1.30 Page 6 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. Ealing House Residential Home I55 s33998 ealinghouse v233489 160605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Ealing House Residential Home I55 s33998 ealinghouse v233489 160605 Stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The home uses a proper assessment procedure and the provider visits prospective residents prior to admission to ensure their needs can be met. EVIDENCE: Care files were checked, and contained evidence that a robust procedure is followed when assessing prospective residents. The information gathered is then used to begin compiling the residents care plan. Ealing House Residential Home I55 s33998 ealinghouse v233489 160605 Stage 4.doc Version 1.30 Page 9 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 standard(s) 7, 8 Care plans for existing residents are very good with clear guidelines regarding needs and how they are to be met. Care plans for new residents are not being compiled soon enough following admission, leaving staff without guidelines in how to meet their needs. EVIDENCE: Care plans have been updated and improved since the previous inspection. They provide a more focussed approach to residents’ needs and concentrate on their abilities and how they like their needs to be met. A resident had been admitted in May, but assessments and the plan of care had not been started. Evidence was seen on the daily record that this resident had needs that were not formally identified. Information in addition to the preadmission assessment needs to be gathered as soon as the resident is admitted, and reviewed frequently, to ensure that needs are being identified. A requirement has been made regarding this. Care plans indicated that residents’ health needs were being met, and they received visits from health specialists as required. Staff demonstrated a good understanding of individual residents needs, and clearly understood how to care for each person.
Ealing House Residential Home I55 s33998 ealinghouse v233489 160605 Stage 4.doc Version 1.30 Page 10 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 standard(s) 12, 13, 14 and 15 Residents are enabled to make choices where possible about their lifestyle, contact with family, friends is encouraged, and the meals provided are well prepared and presented. EVIDENCE: Lots of interaction was going on between staff and residents, music was being played, and residents were singing and dancing. One resident was helping the staff with household tasks, which they clearly enjoyed doing. Staff prepare meals using fresh ingredients and sit and eat with the residents. Lunch looked nutritious and appealing, and care had been taken when serving to ensure individual residents got what they wanted. Alternative meals were cooked to order, as not all residents wanted the choice of meal provided. Residents advised they were able to get up and go to bed when they wanted, could choose the food they liked to eat, and were able to have visitors at any time. Routines were observed to be flexible, and where possible, residents were enabled to manage their daily routine how they wished. Lots of activities are arranged during the day, from staff one to one, to group craft work. Residents appeared happy and contented, and responded well to the staff. Ealing House Residential Home I55 s33998 ealinghouse v233489 160605 Stage 4.doc Version 1.30 Page 11 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 standard(s) Not assessed on this occasion. EVIDENCE: Ealing House Residential Home I55 s33998 ealinghouse v233489 160605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 19 and 26 Residents live in surroundings that are pleasant and homely. Good infection control measures are practiced ensuring residents are protected. EVIDENCE: The home is comfortable, clean and pleasant smelling. Residents’ benefit from the use of two lounges, a separate dining room and a well maintained enclosed garden. Improvements to the décor are continuing, one bedroom has been fitted with a new carpet, and the downstairs bathroom has been completely redecorated. The risk of infection has been reduced by the provision of hand washing facilities, gloves and aprons and antibacterial hand rub. Ealing House Residential Home I55 s33998 ealinghouse v233489 160605 Stage 4.doc Version 1.30 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 Staffing levels are good, and are adjusted according to the needs of the residents. EVIDENCE: At the time of the inspection, there were three care staff on duty, one was cooking, and two were providing care. The provider has increased staffing for a few hours in the morning, as residents need a lot of assistance at that time of day. At the present time there are three care staff on duty in the mornings, two in the afternoon and evenings and one at night. The provider and two senior care staff take it in turns to provide on call back up throughout a twenty-four hour period, and can attend the home quickly if needed. Ealing House Residential Home I55 s33998 ealinghouse v233489 160605 Stage 4.doc Version 1.30 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 With the exception of the hot surface of the radiators, the environment is safe. Residents will be better protected by the installation of a safer heating system, due in October 2005. EVIDENCE: The heating is provided by uncovered storage heaters, which have been switched off during the summer months. The provider plans to change the heating system to provide a safer form of central heating. A requirement was made at the previous inspection for a proper heating system to be installed by end October 2005, and this has been repeated. Hot water taps have been fitted with temperature control valves, and window restrictors have been installed. Ealing House Residential Home I55 s33998 ealinghouse v233489 160605 Stage 4.doc Version 1.30 Page 15 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x 2 Ealing House Residential Home I55 s33998 ealinghouse v233489 160605 Stage 4.doc Version 1.30 Page 16 Are there any outstanding requirements from the last inspection? one is outstanding as the date for compliance has yet to be reached. 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. 1. Standard 7 Regulation 15 Requirement The Registered person must ensure that care plans for new residents begin to be compiled soon after admission. The Registered person must provide a safe heating system that can be individually controlled to include guarded or guaranteed low surface temperature radiators. Repeated as timescale not reached. Timescale for action 31st July 2005. 31st October 2005. 2. 38 23 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. Refer to Standard Good Practice Recommendations Ealing House Residential Home I55 s33998 ealinghouse v233489 160605 Stage 4.doc Version 1.30 Page 17 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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