Inspection on 16/06/08 for East Green House

This inspection was carried out on 16th June 2008.

CSCI found this care home to be providing an Good service.

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

East Green House 03/07/06

East Green House 19/01/06

East Green House 13/10/05

East Green House 25/01/05

East Green House 29/06/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE East Green House The Green West Auckland Co Durham DL14 9HH Lead Inspector Nic Shaw Key Unannounced Inspection 16th June 2008 9:00 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 East Green House DS0000031692.V367877.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. East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service East Green House Address The Green West Auckland Co Durham DL14 9HH 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) 01388 832218 P/F www.durham.gov.uk Durham County Council Mrs Christina Barnett Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39), Physical disability (8) of places East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd July 2006 Brief Description of the Service: East Green House is registered for 31 Older Persons not falling within any other category and 8 persons with a physical disability (PD)(E). It is a well-established local authority home situated in the West Auckland community, close to amenities such as churches, clubs, pubs and shops, with good road and public transport links to Bishop Auckland, Durham and Darlington. All bedrooms are single occupancy. The home provides a range of individual/separate lounges on both the ground floor and the first floor, offering a wide choice for residents including smoking and non-smoking areas. A shaft/vertical lift is provided between ground and first floor as well as stairs for the more able. The home provides long term and respite/short stay services. Dedicated accommodation is provided, together with specialised facilities, equipment and staff to deliver short-term intensive rehabilitation to enable residents to return home (Intermediate Care). There is an attractive, well-tended garden to the rear of the home with seating and good access for the people who live there. The weekly charge for permanent residents is £432. Intermediate care is free for the first six weeks. East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. Before the visit: We looked at: • Information we have received since the last full visit on 3rd July 2006. • How the service has dealt with any complaints & concerns since the last visit • Any changes to how the home is run • The views of people who use the service and their relatives and staff. We did this by sending out surveys. Sixteen residents, ten relatives and four staff completed these and sent them back to us. The Visit: An unannounced visit was made on 16th June 2008 During the visit we: • Talked with people who use the service, relatives and staff • Joined residents for a meal and looked at how staff support the people who live here • Looked at information about the people who use the service and how well their needs are met • Looked at other records which must be kept • Checked that staff had the knowledge, skills and training to meet the needs of the people they care for • Looked around parts of the building to make sure it was clean, safe and comfortable • Checked what improvements had been made since the last visit. The manager was on holiday at the time of the visit but senior staff were able to help us. We later telephoned the manager to tell her what we found. What the service does well: There are good admissions procedures so residents know that East Green House will be able to meet their needs. The staff and manager make sure that residents get to see their doctor or other health care professional, such as the district nurse or occupational therapist, quickly if they need to. The Intermediate Care service is excellent as this provides people with the support and health care they need so they can return home. East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 6 Residents are treated with dignity and respect. And relatives and friends can visit the home any time they wish. Mealtimes are a pleasant occasion, the food is excellent and the home is clean and fresh. There are good safeguarding procedures in place, which protect people, and every one said they felt safe in the home. Staff training is good. As well as NVQ level 2 and 3 training in care being provided, most of the staff have had specialist training in the needs of people with dementia. There are also good recruitment procedures in place. This is important to make sure only suitable people are employed to work in the home. The home is well managed. The manager is qualified and approachable and has worked hard to make sure that residents receive a good service. Residents said, “we are looked after really well”, “staff chat to everyone”, “the home is always clean”, “I love the place, its my second home”, “cannot fault it”, “you can make choices”, it’s a “home from home”, “I’m happy here”, Relatives said “they involve the family and do everything possible to make residents as comfortable as they can”, “individual help is always given”, “good level of care”, “it caters for her (family member) in the best possible way it can to give her a better life”, “provides a happy safe, secure environment for the elderly, provides a “family atmosphere” and my mother looks on East Green as her home not a hospital or somewhere she doesn’t want to be”. Staff said “I love working here”, “its great here”, “the establishment I work at always puts the clients first. We have an excellent manager and the supervisors and staff are all friendly”, “it provides a much needed service to those unable to remain in their own homes”, and “it provides a high standard of care, staff are trained friendly and approachable”. What has improved since the last inspection? What they could do better: Residents need to be provided with a contract so that they know what their rights are. East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 7 Care plans need a bit more information in them so that staff know exactly what they need to do to meet the residents health and personal care needs. Although risk assessments are carried out for those people who look after their own medicines, these need more information in them to make sure that residents get the support they need to remain independent. Activities and opportunities for residents to use community facilities needs to develop. The complaints procedure also needs to be available in alternative formats, for example, in large print, so that people with a visual disability can read it. Many parts of the environment need attention. For example: much of the furniture is old and worn, the baths are rusted, some of the carpets are old and stained and some of the resident’s bedrooms need re-decorating. Someone who does not work in the home must visit the home each month. They must look around the home, talk to residents and write a report for the manager about their visit. This is important to make sure people receive a good service. It’s also a legal requirement. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. East Green House DS0000031692.V367877.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 East Green House DS0000031692.V367877.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 6. Quality in this outcome area is good. We have made this judgement using a range of evidence, including a visit to this service. Good assessment processes ensure that potential residents’ needs can be met at East Green House, however, residents do not know about the terms and conditions of residency and therefore their rights are not fully protected. People who receive intermediate care are helped to maximise their independence and return home. EVIDENCE: The manager always obtains a copy of the social work assessment before a person is admitted to the home for intermediate care, for a short break or on a permanent basis. During the inspection the senior on duty made sure that a social worker who had contacted the home to arrange for a person to receive intermediate care, East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 10 sent to them details about the person’s care needs before their admission. Permanent residents said that their social worker had completed an assessment with them before they moved to the home. Wherever possible the manager meets with both prospective permanent residents and people who are to be admitted for intermediate care. This is so that she can complete the home’s assessment documents with them. The assessment visit also involves the occupational therapist for intermediate care clients. Wherever possible prospective residents and or their families are invited to visit the home before their admission. One resident commented “I had stayed at East Green on a previous occasion and enjoyed my stay and knew I would like to stay on a permanent basis”. Half of the residents who responded to surveys said that they had not received a contract. This was discussed with the person in charge who confirmed that they were aware of this and were in the process of contacting the social workers about it. There is dedicated accommodation for those people admitted for intermediate care, with separate staff. Specialist staff are available, such as occupational therapists, who work closely with care staff and those people staying for intermediate care, in order to promote mobility and self-care. Staff said “there is not one person who leaves (intermediate care) without saying thanks”. East Green House DS0000031692.V367877.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. We have made this judgement using a range of evidence, including a visit to this service. The health care needs of residents are fully met to an excellent standard. And although the health and personal care needs of residents are generally reflected in the care plans, these are not written in a person centred way to ensure that continuity of care is provided to everyone in the way that they prefer. Staff care practices preserve the dignity and privacy of residents. And medication administration procedures fully protect people. EVIDENCE: Care plans are developed based upon information from the home’s six week assessment document. The action plan identifies each individual’s needs and the action required of staff to meet these needs. Key workers are responsible for writing the care plans and keeping them up-to-date if a person’s needs change. They are regularly evaluated and some residents have signed their care plan to show that they had been involved in writing them. East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 12 Where possible key workers are matched to residents according to gender. Generic risk assessments are also completed for each person, however, these mainly focus upon keeping people safe and are not individualised or person centred. For example: there is a generic risk assessment for “drowning in bath” with action “only fill bath to hip level” with no further information as to the individual’s personal preferences or evidence that the person is at risk of drowning. There is also a generic risk assessment for night time checks which includes a list of risks such as falling out of bed and “taking ill”. It was not clear from looking at this as to whether a person was at “high” risk and therefore needed to have a check during the night. It also does not include whether or not a person actually wants to be checked during the night. There is no nutritional assessment tool in use but there is a “needs analysis” completed in relation to diet. This is used to establish an individual’s preferred portion size and if there are any special needs in relation to fluids. Where it has been identified that a person is nutritionally at risk, food and fluid charts are completed to monitor this. These, however, need more detail as comments such as “fair diet” do not provide enough information to judge if a person’s food intake has been good. There are good moving and handling risk assessments completed. These include information about the type of equipment a person’s needs and the number of staff needed to support them. For one person in receipt of intermediate care in their social work assessment it had been identified that they needed assistance with lower garments, for speech to be loud and clear and to cut food if required. However, none of this information had been developed into an action plan. There were no clear goals identified in the intermediate care records to support the positive work that was clearly taking place. The manager has identified this as an area for future improvement. Everyone said that they felt that their health care needs were met at East Green House. People who are at risk of developing pressure sores have been provided with special pressure relieving cushions. For those people who stay at East Green House for intermediate care there is regular contact with occupational therapists and the Rapid Response Team. This is an excellent aspect of the service provided, as staff work closely with these health care professionals to make sure that people are provided with the support they need for their health to improve, enabling them to return to their own home. There are also regular visits from GP’s and other health professionals including, district nurses, optician and chiropody services. Senior staff are responsible for ordering and administering medication, which is kept in a secure area of the home. The majority of medication is pre-packaged East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 13 and dispensed by the chemist in a monitored dosage system (MDS). Senior staff read the instruction on the Medication Administration Record (MAR) and check this against the information on the MDS before they administer medication. This was done in a discrete, careful, sensitive way. There were no gaps on the MAR sheets seen and clear records were maintained. Where residents are able to look after their own medication this is encouraged by staff. A risk assessment is completed in relation to this. However, the risk management strategy was brief with the direction “to monitor medication is taken according to GP instruction”, with no further information about how this is to be achieved. Staff treated the residents in a dignified, respectful manner. For example, residents were not rushed when staff supported them and their preferred name was used. One relative said that the staff always made sure that the residents “dignity is maintained, not like other places”. Other relatives said: “Disabled care is very good” “They respect my mother’s individual needs and meet them accordingly” “All the staff are very helpful at all times and respect patients (residents) privacy and needs, nothing is too much trouble”. “The care she receives at East Green House is better than when she was in hospital”. Residents commented in surveys that they “always” receive the care and medical support they need. One person said, “couldn’t wish for better” another said, “I’m looked after very well”. East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. We have made this judgement using a range of evidence, including a visit to this service. Residents have opportunities to make choices in daily routines and menus so that they lead a lifestyle that matches their individual preferences. However, further attention needs to be given to social and community activities to ensure their well-being is fully promoted. EVIDENCE: Residents spoke positively about the crafts activities that take place every fortnight saying “the create woman is good”. On the day of the inspection visit a hairdresser was visiting. Newspapers are delivered for those people who want them and residents said posters are put up if there are any activities “coming up”. One person goes out to the local club and in this way maintains contact with the local community. However, there is no activities co-ordinator and there is no planned programme of activities. Although five residents commented that there were “always” activities arranged by the home that they could take part in, a further East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 15 five commented that there were only “sometimes” activities and two people said there were “never” any activities they could take part in. One resident said “need more activities/entertainment to relieve boredom. Would like to go on day trips” and one relative said “more facilities to alleviate boredom, more entertainment, for example, sing alongs, demonstrations”. The manager has identified that activities is an area that could be developed further and hopes to employ a part time activities co-ordinator. In the domestic skills assessment form there was some information about the resident’s preferred social activities. However, this information was brief with only space for one line of information about a person’s hobbies and interests. This type of information is very important in person centred care and needs to be developed further. A Methodist Minister visits one resident when they stay in the home for a short break. However, the local Priest no longer visits the home. Staff have tried to address this issue with the local Church, however, with little success. The manager is considering contacting the Salvation Army, as an alternative way of meeting people’s spiritual needs. Friends and visitors are able to visit their family member when they wish and visitors commented, “I feel welcome and can visit anytime”. Relatives said, “ There has only been one occasion when my mother needed to speak with me and the home went out of their way to find a contact number to make this possible”. Residents said “very good communication between family and home” Residents are able to choose how to spend their day. One resident likes to have a lie in bed. Staff respect this. Residents have a choice of smoking or none smoking areas and can independently spend time in the safe, enclosed pleasant garden area. Everyone commented positively about the quality of meals. Comments received included “ the foods very good”, “we are well fed, “our dietary needs are catered for”, and “the foods very good”. Residents confirmed that an alternative is always available. A visitor commented that they had heard other people talk about being pleased to be back because the food is so good. The lunchtime experience for people was good. The dining tables were nicely presented and people could eat their meal at a pace that suited them. East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 16 Senior staff meet with the residents and ask them about the menus. Their comments are then given to the cook who is in the process of reviewing the menus. East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. We have made this judgement using a range of evidence, including a visit to this service. There is a good complaints procedure, however, this is not available in alternative formats, which will prevent some people from expressing their views. Good safeguarding procedures ensure that residents are fully protected from abuse. EVIDENCE: The local authority compliments, comments and complaints procedure is on display in the home. This procedure, however, was not available in large print, nor was it specific to East Green House which would be beneficial as it would help everyone living at the home, or involved in with the service, to complain or make suggestions for improvement. Everyone spoken to said that they knew how to complain and would have no hesitation about doing so if they were unhappy. One person said that they had made a complaint. Discussion with senior staff confirmed that their views had been listened to and acted upon and a record of this complaint was held securely in the manager’s office. There has been one complaint, referred to above, made since the last inspection, which was dealt with within the home’s specified timescale. East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 18 A record of compliments is also maintained and many thank you cards are displayed in the intermediate care unit from people expressing their satisfaction with the service provided. All of the staff are fully trained in the safeguarding adults procedures and know how to respond in the event of an alert. Residents said that they felt safe in the home. East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 and 26. Quality in this outcome area is adequate. We have made this judgement using a range of evidence, including a visit to this service. Although clean and hygienic, East Green House does not offer residents a well maintained place to live. EVIDENCE: Although there have been some improvements to the home in the last year, for example, some lounges and the medication room have been re-decorated and the doors to the garden and some windows throughout the home have been replaced, the remainder of the home needs attention. Residents bedrooms: In some bedrooms the wallpaper is badly damaged, carpets are old and furniture is worn and shabby. One resident said that they liked their bedroom, East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 20 but because of its size they could not fit a chair in for their visitors so they have to sit on the commode. Bathrooms: On the ground floor the bath has been damaged by the assisted bathing facility and the wallpaper is damaged in here. In another bathroom the enamel on the bath is rusted, a potential hazard as a person could tear their skin on this. Lounge/Dining areas/Corridors: The carpet in the corridor is badly marked. Much of the furniture is old and worn in communal areas. For example: pieces of paper have been wedged under some dining room tables to keep them even. The carpet in the smoking lounge is frayed in places exposing the carpet grip. The cupboard drawers in the kitchenette on the first floor are damaged as is the wallpaper and ceiling in here. General: Paintwork on doors is damaged from trolleys and wheelchairs. Two relatives commented in surveys when asked about how they felt the service could improve “refurbishment of client’s rooms, redecorating and lay new carpet and general “facelift” to public areas” and “rooms in need of decorating and up-dating”. The manager is aware of the need to improve the environment and is in discussion with the local authority about this. There is a spacious garden with a summerhouse. This is a pleasant area that people can use in the warmer weather. Staff knew about infection control and used protective gloves and aprons appropriately. All of the staff have completed training in infection control. The home smelt fresh and was clean. Most residents commented in surveys that the home was always clean. East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are sufficient. This ensures residents receive person centred care. Staff training is good, including specialist training to meet the diverse needs of the residents. This enables staff to effectively meet the care needs of everyone living in the home and those people who stay for intermediate care.. Staff recruitment procedures fully protect the residents. EVIDENCE: The home currently provides 2 care staff on duty on the intermediate care unit for a total of 8 people, and 3 care staff for 19 permanent residents and 2 people staying for a short break. There is also always a senior on duty in charge of the home. There are consistently enough staff to meet the health and personal care needs of the residents as the manager uses agency staff to cover for short notice staff sickness and holidays. Nineteen staff have completed the NVQ level 2 qualification in care and 4 staff are working towards the NVQ level 3 qualification. The majority of staff have East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 22 completed training in dementia and in the last year 2 staff have completed “back to basics” training and a further 2 staff training in nutrition and health. All new staff complete a “work based induction booklet” which gives them information about health and safety issues, personal safety and key policies. New staff are then required to complete a 6 month induction, linked to their probationary period, where they are set tasks to complete in order to assess their competency. The home employs sufficient domestic and catering staff. There is one domestic vacancy and the manager is in the process of recruiting staff for this. The home also has a clerk, who manages administrative and financial matters. It was clear that residents enjoy a good relationship with staff. Residents said “ the staff are marvellous, wonderful and patient”, “they do their best”, “you couldn’t find any better staff anywhere” and “everyone is always willing to help”. Relatives said “all the staff are very helpful at all times, nothing is too much trouble”, and “the staff do an excellent job and do their best to look after everyone. As the manager was on holiday it was not possible to look at the staff files as these are locked securely away. However, when we talked to her after the visit she confirmed that all suitable checks and clearances are up-to-date for all permanent staff as well as agency staff. East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Quality in this outcome area is good. We have made this judgement using a range of evidence, including a visit to this service. Overall the home is well-run, in a way that upholds the best interests of the people who live here, and ensures their health, safety and welfare are protected. However, the quality assurance process must improve to ensure that residents continue to benefit from a good service. EVIDENCE: The manager has 8 years experience as a manager in residential care. She is a Registered General Nurse (RGN) and has completed the NVQ level 4 qualification in management. Residents said “the manageress is very fair, she will sit and talk to you” and “the manageress comes in (the lounge) regularly”. East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 24 Staff said, “the manager is very approachable” and “the manager has always been available to talk with me and has been very supportive”. There are clear lines of accountability within the home. Senior staff take charge in the manager’s absence and are responsible for the supervision of staff. As well as one to one supervision meetings with staff this includes a direct observation of care practice. Residents’ views are sought via satisfaction surveys. The home also holds residents meetings. Senior staff do weekly health and safety checks of the building, and the manager does her own audit of the service each month. However, no-one form within the organisation visits the home each month to talk to residents and to audit aspects of the environment to make sure that a good service is being provided. This is a legal requirement. The homes clerk supports some residents with the safe storage of their personal monies, if they wish. The local authority regularly carries out an audit of the residents’ finances. Staff receive training in statutory health and safety matters, so that they know how to support residents in a safe way. An appropriate record is maintained of accidents. The manager also monitors the occurrence of these which helps to identify any themes or trends for which preventable action could be taken. East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 X 2 3 X x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X 1 X X X X 3 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 3 X 2 X 3 3 X 3 East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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 OP2 Regulation 5(1)(b) Requirement Residents must be provided with a contract so that they know their terms and conditions of residency. Medication risk assessments must be developed to include more information about what support each resident needs to remain independent in this area. Opportunities must continue to develop for residents to take part in a range of social and community activities. This is to ensure the well-being of the residents. The complaints procedure must be available in large print so that people with a visual disability can read it. The registered provider must produce a comprehensive refurbishment plan, based on an audit of the environmental needs in the home and detailing timescales for implementation to improve the environment. This must include:Residents’ bedrooms where the East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 27 Timescale for action 31/12/08 2 OP9 13(2) 31/08/08 3 OP12 16(2)(m) 31/12/08 4 OP16 22 31/12/08 5 OP19 OP21 23 31/08/08 paintwork and furniture is damaged. Dining areas including the quality of dining furniture, furniture in all communal areas and carpets where these are old, worn and stained. The rusted baths. A copy of this plan must be forwarded to us. The responsible individual, or an 31/08/08 employee of the local authority, not directly concerned with the conduct of the home, must visit the home once a month. They must inspect the environment and speak with residents in order to make a judgement about the standard of care. This is to ensure that residents continue to be provided with a good service. 6 OP33 26 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 OP7 Good Practice Recommendations Care plans should continue to develop with a focus upon person–centred care. For people who receive intermediate care, clear goals should be identified with action plans to show how each goal is to be achieved. Food and fluid charts need more information. This is to make sure where a person is at risk of nutritional malnutrition this is effectively monitored. It is recommended that a complaints procedure be developed which is specific to East Green House. This is to DS0000031692.V367877.R01.S.doc Version 5.2 Page 28 2 OP16 East Green House make this easier to understand so that everyone knows who they can speak to in the home if they are unhappy or have concerns. East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI East Green House DS0000031692.V367877.R01.S.doc Version 5.2 Page 30 - 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!