Inspection on 25/06/06 for Eastside House Rest Home

This inspection was carried out on 25th June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Eastside House Rest Home 10/07/06

Eastside House Rest Home 08/11/05

Eastside House Rest Home 10/05/05

Eastside House Rest Home 12/10/04

Eastside House Rest Home 07/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Eastside House Rest Home 22-24 Eastside Road Golders Green London NW11 0BA Lead Inspector Jackie Izzard Key Unannounced Inspection 09:30 4th July 2007 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 Eastside House Rest Home DS0000010403.V337218.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. Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eastside House Rest Home Address 22-24 Eastside Road Golders Green London NW11 0BA 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) 020 8455 4624 020 8458 0739 Mrs Rosalind Virasinghe Therese Josiane Moutou Care Home 16 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (16) of places Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Limited to 16 people of either gender who fall into the category of old age (OP) and who may have dementia (DE(E)). 10th July 2006 Date of last inspection Brief Description of the Service: Eastside House Rest Home is a privately owned care home which is registered to provide personal care and support for up to sixteen people of either gender. The home is located in a residential area close to Temple Fortune, Golders Green and Brent Cross shopping centre. There are very good transport links with shops and amenities close by. The home consists of a two storey detached building with a small car park at the front and a large attractive garden at the rear of the premises. Accommodation is provided in single rooms on the ground and first floor. None of the rooms have en suite facilities but each has a hand washbasin. There is a passenger lift available to the first floor. There are two bathrooms with two toilets on each floor. Two separate toilets are also provided for residents and one for staff. The stated aims of the home are to provide care for people who are physically disabled or elderly and are unable through physical or mental frailty to care for themselves. The cost of placements for residential care is £550.00 per week. Following Inspecting for Better Lives the provider must make information available about the service, including inspection reports, to residents and other stakeholders. Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took one day to complete. The manager, Mrs Josie Moutou, assisted the inspector throughout the day. The inspector was able to speak in confidence to three relatives of residents and ten residents individually during the inspection. She met fifteen of the sixteen residents of the home. The other person was in hospital on the day of the inspection. The inspector was also able to speak to the owner of the home, the manager, one care staff, one domestic assistant and the cook. The inspector completed a tour of the building, looked at the care plans for five residents, and examined the medication administration recording and storage arrangements. A sample of the home’s policies and procedures were inspected and the requirements made at the previous inspection reviewed. The inspector also examined the complaints records, a sample of health and safety records, staff recruitment, training and supervision information and staff rotas. What the service does well: What has improved since the last inspection? Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 6 Four requirements were made at the previous inspection. Three of these requirements are fully met while one is not met. The improvements made were in the area of care planning, reporting events to CSCI and in medication. 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. The summary of this inspection report can be made available in other formats on request. Eastside House Rest Home DS0000010403.V337218.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 Eastside House Rest Home DS0000010403.V337218.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 People using the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s needs are usually assessed well using comprehensive assessment tools but the registered persons must ensure that this happens for all residents. People referred for intermediate care are helped to maximise their independence and return home. EVIDENCE: In order to ascertain whether people’s needs had been assessed the inspector looked at the files of five residents. The home has a comprehensive set of assessment documents covering a person’s needs in every area. Four of the five residents had their needs fully assessed but one had an incomplete assessment in her file. Some of the information was unclear (eg whether or not the resident has diabetes) and Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 9 some important areas of need had not yet been assessed. A requirement is made to complete this person’s assessment. One person was staying at the home for intermediate care at the time of this inspection. The inspector was able to meet privately with this person and was informed that s/he had received a good service whilst at the home and was shortly due to return home which was very positive. Eastside House Rest Home DS0000010403.V337218.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents at this home receive a very good standard of personal care and their health needs are well met. They are well cared for and treated with respect. Medication practice and monitoring needs to be more robust to protect residents from risk of errors with their medication. EVIDENCE: The inspector looked at the care plans, risk assessments, health records and medication administration charts for a sample of five residents in order to assess these standards. Staff had assisted people with caring for their hair and clothes, using make up and jewellery etc. One resident told the inspector that earlier that day the staff supporting her with dressing told her that her skirt was creased and took it away to iron it for her. This was one example of a good attention to detail which residents said they appreciated. Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 11 Another resident said that the personal care and attention given by staff was “excellent”. Residents felt that care staff respected them and tried to meet their requests. The physical appearance of residents was also observed along with talking to ten residents about the standard of personal care they receive at the home. The inspector observed that all residents appeared to be well cared for physically. One said, “the girls cannot do enough for me. I think I get special treatment.” Care plans are mainly based on people’s physical needs along with a record of their daily routine. The plans are reviewed monthly as required and updated if there have been any changes to that resident’s needs in the preceding month. Some care plans also addressed the social and activity needs of the residents. The home records when residents attend health appointment s and the manager said that the home has a good relationship with a local GP who comes to the home whenever requested. Residents said they receive physiotherapy and chiropody services which the home arranges but they pay for privately. A sample of medication charts were inspected along with medication in the cabinet. A number of errors were found and requirements are made to improve medication practice. One person ‘s chart showed that s/he was being given an incorrect dose which was not the dosage recorded on the medication. Another’s medication had run out. One had missed a dose of medication and no explanation for this had been recorded on the chart. Another person was being given a different dose to the dose recorded on the medication container. The manager said that the change in medication was agreed by the GP by telephone. It was explained that there is therefore no evidence that a change of medication had been approved by a doctor and that the GP should be asked to record or to sign that a change has been approved. Although none of these errors had resulted in any harm to residents, medication monitoring must be improved to avoid risk of harm. Eastside House Rest Home DS0000010403.V337218.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 People using the service experience good outcomes in this area This judgement has been made using available evidence including a visit to this service. People enjoy leading the lifestyle of their choice where they are able to and their visitors are welcome in the home. A very good quality of food is served. Residents would benefit further from being offered opportunities to take part in trips out and more activities within the home. EVIDENCE: Residents expressed a good level of satisfaction with the home. The inspector spoke privately with ten residents who said they were happy there. People are encouraged to live the lives they were leading prior to moving into a care home. Some residents go out regularly with family and friends and retain their previous social life, which is very positive. The only suggestions for improvement were in the area of recreation. Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 13 Each resident had an activities and interests assessment on file but there are limited activities provided by the home. Those who are able to occupy themselves with reading, talking books, television and outings with family and friends. The home provides a weekly exercise class where an external visitor runs the class and entertains residents. Some residents enjoy this. The owner said that a volunteer visits on Fridays to chat with residents. This is very positive. However there a number of residents with failing sight and hearing who said they find it difficult to continue with their interest in reading, knitting and watching television and could become isolated socially. The owner went for a walk to local shops with a resident during the inspection which is a regular occurrence. There is no programme of outings for other residents. This was discussed with the registered persons who said that there have been more in-house activities in the past but residents were not participating. Three residents told the inspector they would like to go out more. One also suggested organised games of scrabble, whist and Bridge. These suggestions were passed to the registered persons. Ideas for trips out include shopping and short walks in the local area, trips to the coast and meals out. A requirement is made to consult residents and develop an activities programme which includes activities in the home and trips into the community. Religious needs are met. Some people go out to church and some are visited by members of their church. Staff support residents in maintaining relationships with their relatives and friends. Visitors are welcomed and offered refreshments and given the opportunity to discuss their relative’s care with staff. Feedback from three relatives spoken to was very positive about the ways they are treated by staff. The quality of food provided in the home is excellent. On the day of the inspection lunch was a choice of salmon or omelette with vegetables and/or coleslaw with three types of potato on offer. Dessert was trifle or fresh pear. The fish was served with a sauce and wedge of lemon and residents said they appreciated these small touches to make the meal appetising. Residents praised the food and said the chef consults with them every day to see what they would like. The menu shows a choice of two dishes at each meal. The inspector was able to join a table of residents for lunch. Food was served attractively and was well cooked. Residents said the menu is the same from week to week and they like it as they know what they will be having. A number of residents told the inspector it would be salmon for lunch on the day of the inspection. Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 14 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, 18 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are confident that they will be listened to. They are protected from abuse by staff who have been provided with training in protecting them. EVIDENCE: The home’s record of complaints was inspected. There had been three complaints in the last year, all of which have been resolved. There is a clear procedure for making a complaint. The inspector asked three residents if they knew how to make a complaint. All said they would complain to the manager and were confident about doing so. They also said that their views were listened to. Staff have been provided with training in protecting people from abuse and how to respond to a disclosure or suspicion of abuse. On this occasion the inspector did not check whether all staff have had this training. The home has a robust adult protection procedure, which was reviewed in May 2006. . Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 15 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, 24, 26 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents enjoy a homely comfortable environment which is well maintained and kept at a good standard of hygiene and décor for them. EVIDENCE: The inspector undertook a tour of the building and garden. There was evidence that care is taken to provide a comfortable homely environment which is well maintained. Personal touches such as pictures and plants were in communal rooms. The standard of cleanliness throughout the home was very high. One exception was one bedroom where there was an odour. This was discussed with the registered persons and the inspector was confident that this would be remedied without delay. Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 16 The décor and furnishings were tasteful and of good quality. Bedrooms were all decorated in a neutral colour and people had personalised their own rooms where they wished to. The residents have their own telephones in their rooms. The home has two baths which few residents can use now due to their limited mobility. The inspector was informed that the registered person intends to replace two baths with showers which will be more suitable for older people to use. There are laundry facilities and residents said that their clothes are laundered well. The home has a policy of not allowing fridges or kettles in bedrooms and this was discussed as one resident would like both. The reason for the policy of no kettles was reported to be for safety reasons. The inspector advised that the policy on having personal fridges be reconsidered. Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 17 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, 30 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff employed at Eastside House are properly recruited to protect residents from risk. Staff receive training that assists them to deliver a better quality of care and residents consider them to be competent and caring. EVIDENCE: The inspector was able to examine rotas in the home, look at a selection of staff recruitment records and training records. In addition, the inspector spoke with the manager, a domestic assistant and the cook and observed three care workers in their interactions with residents over the lunchtime period. The inspector also asked residents in private for their views on the staff in the home. Staff numbers are sufficient for the needs of the service users. At the time of inspection, four care staff; two domestic staff and the cook were in the home excluding the manager and the owner. In the evening the number of care staff reduces to two. The manager and three residents all said that at this time this Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 18 staffing level is adequate to meet needs. All staff have either completed or are working on NVQ Level 2. One new staff member has been employed since the previous inspection. This staff member was properly recruited with all relevant documentation in place and had been provided with induction training. A sample of training records showed that staff have received training in communication with people with dementia, control of infection, prevention of pressure ulcers, food hygiene and fire prevention, dementia care, health and safety, moving and handling and medication. Both the cook and domestic assistant showed a pride in their work and were praised by residents as doing a very good job for them. The residents said that all care staff were caring and kind and that they were very happy with them. Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 19 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, 38 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the residents and is well managed. The health and safety of residents is generally well protected but there is no written fire evacuation procedure to guide them in the event of a fire. EVIDENCE: The home is run by an experienced manager. The residents said they were satisfied with the manager and two said that she was extremely caring and ensured that their needs were always met. The inspector spoke with ten Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 20 residents of whom eight were able to give clear views on the home. All said that the home was run in the best interests of the residents. This year’s quality assurance exercise was not inspected on iths occasion. The owner of the home does not produce the monthly reports on the home as required of home owners by regulation 26 of the Care Homes Regulations 2001. She said this had been agreed by CSCI previously as she attends the home every day so is fully up to date with events and takes an active role in the daily life of the home. The inspector saw records which showed that the manager supervises night staff as well as the day staff. Supervision notes for one staff member were checked and the inspector saw that supervision was taking place every two months which is good practice. A requirement was made at the last inspection in July 2006 that the manager must complete the fire procedure by including the home’s evacuation policy. This had not been completed as there was only a diagram of the evacuation procedure available and no written instructions for staff and residents to follow. This requirement is restated with a short timescale of compliance as it is important that all staff, resident and visitors are fully aware of the evacuation plan to follow in the event of a fire. The home does not manage the finances of any individuals in the home. This is managed by relatives and legally appointed individuals. The home routinely carries out health and safety checks including tests of the fire alarm and regular fire drills and ensuring that equipment is serviced. This includes lift servicing and inspection of gas installation, emergency lighting, and emergency call systems. Staff have been provided with the relevant training in health and safety topics to enable them to carry out their duties safely. Details of this training are in the staffing section of this report. Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 21 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 X 2 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X X 3 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 3 X 3 Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? yes 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 OP3 Regulation 14 Requirement The registered persons must ensure that the assessment of a named resident’s needs is completed and recorded. The registered person must ensure that medication procedures and practice are improved, specifically that • Medication is not changed without written instruction from the prescribing doctor The correct prescribed dose is given at all times Staff ensure that prescribed medication does not run out An incident where a resident was not given a dose of medication and no explanation was recorded is investigated and the outcome reported to CSCI. Timescale for action 10/08/07 2. OP9 13(2), 37 31/08/07 • • • Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 23 3. OP38 23(4) (a) (c) The registered person must amend the fire prevention policy and procedure to include the homes evacuation plan. This requirement is restated. Previous timescale of10/09/06 not met. 10/08/07 4. OP12 16(2)(m)( n) 5. OP26 23(2)(d) The registered persons must, after consulting residents and their representatives, devise a programme of activities and outings for residents. A copy of the programme must be sent to CSCI. The registered persons must address the odour in one bedroom. 31/08/07 31/08/07 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 Eastside House Rest Home DS0000010403.V337218.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Harrow Area Office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 - 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. 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