Inspection on 03/07/06 for East Green House

This inspection was carried out on 3rd July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

East Green House 16/06/08

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE East Green House East Green House The Green West Auckland Co Durham DL14 9HH Lead Inspector Mr Leonard Hird Unannounced Inspection 3rd July 2006 09:30 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.V301741.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.V301741.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service East Green House Address East Green House The Green West Auckland Co Durham DL14 9HH 01388 832218 01388 832218 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) 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.V301741.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 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 with its amenities and good road and public transport links to Bishop Auckland, Durham and Darlington. All bedrooms are single occupancy and are equipped and furnished to a satisfactory standard. The home provides a range of individual/separate lounges on both the ground floor and the first floor, offering a wide choice for service users including smoking and non-smoking lounge. 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 and dedicated accommodation is provided, together with specialised facilities, equipment and staff to deliver short-term intensive rehabilitation and enable service users 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. East Green House DS0000031692.V301741.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection of East Green took place on the 3rd July between 0930 and 1330 hrs as well as the 12th July between 0930 and 1200 hrs. The inspection process considered all of the Key standard areas as identified by the Commission for Social Care Inspection within the Care Homes for Older People National Minimum Standards. These Key standards are: Choice of Home (NMS 3 and NMS 6), Health and Personal Care (NMS 7, 8, 9 and 10), Daily Life and Social Activities (NMS 12, 13, 14 and 15) Complaints and Protection (NMS 16 and 18), Environment (NMS 19 and 26), Staffing (NMS 27, 28, 29, 30,) and Management and Administration (NMS 30, 31, 33, 35 and 38). As well as Choice of Home standard (NMS 1) The Commission for Social Care Inspection received 16 written comments from residents, relatives and health professionals as well as verbal comments on the days of inspection from residents, family members, visitors, social workers and visiting health professionals. Comments were also received from the registered manager, members of the care staff team and team manager. What the service does well: East Green was clean, tidy, well decorated and comfortably furnished in a pleasant and very homely way. Residents in both the residential and intermediate care units spoken with were positive in their comments about the home ‘ the staff at the home have helped me get better and enabled me to be more mobile again ’, ‘all of the staff look after us well’ ‘they look after my health by having plenty visits from the nurses and occupational therapists’. Residents were satisfied that they could make choices about what they did there in their lives and commented that, ‘we have the choice to do things that we want to do’. The health and safety of residents was being well managed and staff had received appropriate training to enable them to look after the residents. East Green House DS0000031692.V301741.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. East Green House DS0000031692.V301741.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection East Green House DS0000031692.V301741.R01.S.doc Version 5.2 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 the following standard(s): MMS 1 NMS 3 and NMS 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. East Green provided a Statement of Purpose and a Service User Guide that contained sufficient information for prospective residents to make an informed choice about where they were going to live. East Green ensured that prior to admission to the intermediate and residential care units, suitably qualified staff including where appropriate the involvement of occupational therapists, nursing staff as well the homes care staff had undertaken a full assessment of the needs of the prospective resident. Residents residing on the intermediate care unit were being encouraged to maximise their independence before returning home. . East Green House DS0000031692.V301741.R01.S.doc Version 5.2 Page 9 EVIDENCE: The Statement of Purpose and Service User Guide currently being used at East Green contained sufficient information for prospective residents to both residential units to make informed decisions about the home. The documents were easily read and could be made available in different languages and formats if required. Though some information contained in these documents particularly in the areas of fees and the changing structure of intermediate care in the home was not fully available. A written comment received from resident stated that, ‘they had received enough information on East Green to know that it was the right one for me’. Assessments of needs had been undertaken by suitably qualified and experienced staff of residents before admission to East Green. These assessments of needs records were being maintained on individual residents files. Residents spoken with during the inspection process confirmed that they had been assessed before they had entered the home. One resident commented that ‘they had had an assessment carried out before coming into the home by somebody from the home ’ another commented ‘that they had seen a nurse for their assessment’. Comments received from residents residing at East Green were very positive about the levels of care they received. One resident commented in writing that ‘ I receive all the care and support I need from all of the staff’ another commented that, ‘they definitely received the care and support they needed’. Verbal comments received from residents residing on the intermediate care unit were positive and ranged from, ‘its given me the confidence to get back home again’ ‘I will be able to do things around the house again’ to ‘just ask for something and I get it straight away’. East Green House DS0000031692.V301741.R01.S.doc Version 5.2 Page 10 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): NMS 7 NMS 8 NMS 9 and NMS 10 Quality in this outcome area was excellent. This judgement has been made using available evidence including a visit to this service. Individual residents health, personal and social care needs were being set out in their care plan. Residents were able to make decisions about how they could lead their lives and were treated with respect and dignity. The homes medications policies, procedures, guidance and programme enabled staff to dispense medication to residents safely. training EVIDENCE: Residents living at East Green had individual plans of care in place and information was being maintained on the individual residents health and personal needs. East Green House DS0000031692.V301741.R01.S.doc Version 5.2 Page 11 Assessments of risk were also being included in these care plans. These risk assessments had taken account of individual residents views e.g. whether to self-medicate or not which is of great importance for those residents on the intermediate care unit who were striving for an independent lifestyle. Staff had reviewed individual residents plans of care and where any changes had been identified these had been acted upon. Care staff at East Green had access to appropriate policies and procedures for the receipt, recording, storage handling, administration and disposal of medicines. Records were being maintained of the training undertaken by care staff in the safe handling and administration of medication, infection control and first aid. Visiting occupational therapists and district nurses to the home on the days of the inspection commented that, ‘ the relevant care staff were always available to discuss the needs of both groups at the home and always kept them informed of the progress of the residents’ and that, ‘there were excellent working relationships between themselves and the home and this helped for positive outcomes for the residents’. A written comment received from a resident stated that, ‘I always receive the medical support I need’. A written comment received from a relative stated that, ‘staff at East Green were always caring, friendly and efficient and always inform me of any changes in my mothers health and GP visits’. A resident verbally commented, “I see the doctor or nurse when I need to and the staff look after me”. It was observed during the inspection that all of the homes staff had a very friendly but professional approach to the residents as well as treating them in a respectful and dignified manner. East Green House DS0000031692.V301741.R01.S.doc Version 5.2 Page 12 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): NMS 12 NMS 13 NMS 14 and NMS 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The routines of daily living and activities available at East Green were varied and flexible and generally meeting the needs of the residents. The independence and personal choices of residents at East Green were being encouraged by the home. The dietary needs of residents were well catered for with a balanced and varied selection of food being made available throughout the day. EVIDENCE: It was observed that the daily routines of living were flexible and meeting the needs of both groups of residents. Activities were arranged for residents within the home and residents had been consulted as to the type of activities they would like to take part in. East Green House DS0000031692.V301741.R01.S.doc Version 5.2 Page 13 Records were being maintained of activities undertaken by residents in the home as well as of those organised by the Create program. Residents are encouraged to socialise with friends and family and some residents go to the local Working Mens Club. One resident commented in writing, ‘they do have activities but by choice I dont go because of personal reasons’ another commented, ‘there were afternoon activities which I usually take part in and I also like the weekly Saturday social night and sing songs ’. The home also has regular outside entertainers and celebratory parties for residents. Residents commented verbally that ‘they enjoyed the bingo sessions and Create visits as they did different things’. Residents also commented that they “ that staff let them do things in their own time and not rush them’. Relatives visiting the home spoke well of the homes visiting policy and a relative stated in writing that, “ I have found the management and staff at East Green very courteous at all times, as well as being very helpful in any situation regarding my relations needs’ Menus were being displayed in the home of the different choices of food available and special diets were being catered for where required. A written comment received from a relative stated that, ‘the cooks were providing good varied meals for their relative’. Verbal comments received from residents about the food ranged from ‘the meals were tip-top ’ ‘ I always get two slices of bacon in my sandwich for breakfast ’ to ‘if I dont like something, there is always something different available ’. A written comment received from a resident stated that, ‘I have no fault with the meals they are well cooked and everything is cooked fresh on the premises’. Records were being maintained of the choice of food being made by residents as well as records of the homes Menus. Records of training undertaken by the catering staff including Food Hygiene training were being maintained on their personnel file. East Green House DS0000031692.V301741.R01.S.doc Version 5.2 Page 14 Regular residents meetings were being held and the choices of food and activities being made available at home to residents were regularly discussed and minutes of these meetings were kept. East Green House DS0000031692.V301741.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): NMS 16 and NMS 18 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The complaints and adult protection policies and procedures currently being used in East Green provide for a safe environment for residents to live in. EVIDENCE: East Green had appropriate policies and procedures available for the Protection of Vulnerable Adults. From discussions with staff it was confirmed that they were aware of the importance of acting quickly in cases of suspected abuse and that they would follow the homes policy and procedures if necessary. Staff had received training on how to deal with the Protection of Vulnerable Adults and records were being maintained of this training. Staff confirmed that they had received training in how to deal with the Protection of the Vulnerable Adult. East Green had appropriate policies and procedures in place for residents and their families on how and who to complain to if they needed to. Information on how to complain was being displayed on the notice boards in the home as well as being contained in the residents guide to the home. East Green House DS0000031692.V301741.R01.S.doc Version 5.2 Page 16 A written comment from a resident in response to the Commission for Social Care Inspection’s survey ‘Have Your Say About East Green’ stated that, ‘if I was not happy about things I would ask to see the person in charge’. East Green House DS0000031692.V301741.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): NMS 19 and NMS 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. East Green is clean, pleasant and hygienic and provides a safe and comfortable environment for its residents in both the intermediate and long-term residential care unit. EVIDENCE: East Green had been decorated and furnished to a pleasing and homely standard and took account of the needs of the different residents groups. A resident spoken with commented, ‘ my room is nice and well decorated’ another commented ‘it is how I wanted’. The communal living areas on both the intermediate and long-term residential care units were well decorated and maintained. East Green House DS0000031692.V301741.R01.S.doc Version 5.2 Page 18 Maintenance work undertaken on the homes equipment and facilities by the handyman as well outside contractors had been recorded appropriately. East Green is clean, tidy and free from unpleasant odours. A relative commented in writing that, ‘it is always clean and well run’ another commented that, ‘there were no unpleasant smells in the home’ and a visiting health professional commented in writing that, ‘the home is very clean’ East Green House DS0000031692.V301741.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): NMS 27 NMS 28 NMS 29 and NMS 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. East Green through its recruitment, employment and training procedures were ensuring that only suitably qualified care staff had being employed. Staffing levels at the home were sufficient to meet the current assessed needs of both groups of residents. EVIDENCE: From a review of the staff rota provided it was noted that staff were being deployed in sufficient numbers as to ensure the current needs of both groups of residents were met. There was a commitment to training for all staff at the home and currently 97 of the homes care staff were qualified at NVQ level 2 in care or above and over 50 of staff had a qualification in first aid. Staff had received induction training and there was a rolling training programme operating in the home providing training in moving and handling, dementia training, safe handling and administration of medication, first aid, infection control, fire awareness and the Protection of Vulnerable Adults. Staff East Green House DS0000031692.V301741.R01.S.doc Version 5.2 Page 20 spoken with confirmed that training had been undertaken and that it was beneficial to their position at the home. In documentation sent to the Commission for Social Care Inspection by the homes Registered Manager it was confirmed that staff were undertaking a course in Equality and Diversity. Records were being maintained of all training being given to staff in the home and individual records of training were been kept on the staffs files. All care and ancillary staff employed at the home had being recruited in accordance with the homes policies procedures and that of Durham County Councils. Appropriate employment checks including an enhanced level Criminal Records Bureau check had been undertaken on staff employed by Durham County Council before starting to work at the home. This confidential information had been recorded on the individuals personnel file and the files were being kept securely. However there was a number of other visiting professional staff that regularly came into contact and worked with the residents of both the intermediate and residential care units at the home. Durham County Council did not directly employ these visiting staff and it could not be confirmed that all of the appropriate employment and Criminal Records Bureau checks had been undertaken on these staff. East Green House DS0000031692.V301741.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): NMS 31 NMS 33 NMS 35 and NMS 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. East Green has an established management structure ensuring that the home promotes the health, safety and welfare of residents and Staff. EVIDENCE: There were clear lines of management, accountability and support systems to be found within the home. Formal supervision sessions were being given to all members of the care staff, management team and ancillary staff. East Green House DS0000031692.V301741.R01.S.doc Version 5.2 Page 22 Records of staff supervision sessions were being maintained securely and staff confirmed that they had received copies of their supervisions. From discussions with staff it was confirmed that they were aware of the changing management structure within the home and outside of the home. Comments received from residents, relatives and visitors during inspection were all positive and Minutes were being kept of the regular residents meetings. The responses to the points raised by residents during these meetings from the manager were also being kept. East Green is the subject of regular financial audits undertaken by the Local Authorities audit team. The latest audit records available for East Green confirmed that the home was safeguarding the financial interests of residents. Regular fire alarm tests and fire drills had been undertaken at the home and records were being maintained accordingly. Records were also been were being maintained of when equipment had been serviced and who had undertaken and completed the work e.g. the porter handyman or external contractors. East Green House DS0000031692.V301741.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 X 3 X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 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 3 X 3 X X 3 East Green House DS0000031692.V301741.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? no East Green House DS0000031692.V301741.R01.S.doc Version 5.2 Page 25 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 OP29 Regulation Regulation 19 Schedule 2 Requirement Timescale for action 31/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations East Green House DS0000031692.V301741.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 East Green House DS0000031692.V301741.R01.S.doc Version 5.2 Page 27 - 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!