Inspection on 08/11/05 for Eastside House Rest Home

This inspection was carried out on 8th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 25/06/06

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 Tola Akinde-Hummel Unannounced Inspection 8th November 2005 09:15 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 Eastside House Rest Home DS0000010403.V259201.R01.S.doc Version 5.0 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.V259201.R01.S.doc Version 5.0 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.V259201.R01.S.doc Version 5.0 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 May 2005 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 service users and one for staff. The toilet and bathroom facilities are of a high standard and tiled from floor to ceiling. 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 able to care for themselves. Eastside House Rest Home DS0000010403.V259201.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Eastside Rest Home took approximately 5 hours to complete. The manager Ms J Moutou and the owner Mrs Virasinghe were present and available throughout the inspection. There are no vacancies in the home at present. The inspector was able to speak to three service users and five staff. The inspector was also able to speak to the district nurse visiting the home. At the time of inspection, three care staff were on duty. One domestic staff member was also present. The inspector had a tour of the building, looked at care plans, fire risk assessments, complaints and incidents. The inspector also examined the daily logbook, checked the storage and recording of medication and looked at the menus. All the requirements from the previous inspection were examined. What the service does well: What has improved since the last inspection? The home has fully met two of the four requirements from the previous inspection. Service users have the choice to access a dentists where required. And the kitchen sealant has been replaced to avoid dirt and water penetration. Eastside House Rest Home DS0000010403.V259201.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Eastside House Rest Home DS0000010403.V259201.R01.S.doc Version 5.0 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.V259201.R01.S.doc Version 5.0 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): 3 Service users needs are adequately assessed prior to admission. This ensures that service users and the home can determine if the home suits the needs of service users. EVIDENCE: Assessments completed by the home give information of the needs of service users prior to admission to the home. These assessments cover issues including service users history, physical and mental health, service users interests, and significant relationships. There have been two admissions since the last inspection, records show that family members make enquiries about vacancies in the home and visit prior to relatives being moved there. One new service user stated, “ I was helped to move here by my relatives and I have excellent care here and the staff know what I need and are helpful”. Eastside House Rest Home DS0000010403.V259201.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 Eastside House has made little progress in developing the care plans for service users. The administration of medication is a cause for concern and there is a lack of clear guidelines in place to assure emergency situations are dealt with effectively. EVIDENCE: Five service users care plans were examined. The plans do not consistently record goals relating to achieving optimum health and care of service users. Those plans that do have goals have no detail of how they will be achieved. This was a requirement at the previous inspection this has been partially met as some care plans have improved. Discussions with three care staff about the recording of information on care plans revealed that they did not fully understand the importance of recording information in greater detail. There is concern that following an adult protection where it was identified that there was inadequate recording by the home there has been no improvement. This was clarified with the care staff team on inspection, outlining the need to record and monitor progress of the plan and identify any areas that need to be amended. This issue was also discussed with the manager and the owner. The Eastside House Rest Home DS0000010403.V259201.R01.S.doc Version 5.0 Page 10 manager encourages staff to work together on improving care plans and highlights where further information is required. The manager and owner stated that they would monitor this area with staff in terms of competency. The physical care given to service users continues to be person centred and of a high standard. On examining the records of medication, it was clear that staff are not consistently signing when medication is administered. The home has also accepted medication from the pharmacy where there has been a change to the prescription and the particular medication is no longer required. Staff stated that they had spoken to and written to the pharmacy but could not provide any evidence of this as notes were not recorded. It was made clear that all communication should be recorded and used as a reference should this be necessary. One service user had a fall, which was recorded adequately, however the service user was not immediately referred to her GP following the fall, as the service user did not complain of pain or discomfort. The following day the service user had swelling and was taken to hospital. The home must provide clear procedures to staff following similar incidents about what action they should take such as contacting the service users GP to relay factual information and follow any advice given. The previous requirement to ensure that service users have access to dental treatment has been met. Eastside House Rest Home DS0000010403.V259201.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15 Service users are encouraged to pursue their interests within the home. This ensures they remain comfortable and settled. Relatives and friends are welcomed ensuring positive contact is maintained. EVIDENCE: Service users confirmed that they are supported to pursue their interests. Some listen to their radios and watch videos, one gentleman plays the violin once a week and likes to type. Service users who have expressed an interest in alternative medicines are able to access this from a qualified therapist who visits the home once a week. The home employs a sessional worker to stimulate conversation and encourage service users to take part in activities run by the home. On the day of inspection, ten service users were taking part in a quiz. Service users are visited regularly by their relatives and are able to relate to staff about their relatives in the home. Service users continue to be served with nutritious balanced diets. Pureed food is served in an appetising way and the specific likes and dislikes are well documented. The chef has a good relationship with service users and was observed socialising with a group in the lounge. Eastside House Rest Home DS0000010403.V259201.R01.S.doc Version 5.0 Page 12 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): Standards 16,17, and 18 were examined at the previous inspection and were assessed as met. EVIDENCE: Eastside House Rest Home DS0000010403.V259201.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 The home is maintained to a high standard ensuring that service users live in a comfortable and welcoming environment. EVIDENCE: During a tour of the home it was evident that Eastside House Rest Home continues to be decorated and maintained to a high standard. The home is comfortably furnished, bright and attractive. The communal areas are relaxing and the dining area is adequate with matching dining room furniture. The home has a mature well-tended garden, which is welcoming and furnished well. The home employs two cleaning staff that rotate some duties including the cleaning of furniture and equipment used by service users. The home is clean and hygienic. Eastside House Rest Home DS0000010403.V259201.R01.S.doc Version 5.0 Page 14 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): 28,29 Eastside House properly recruit and train staff in the home, minimising risk and maximising the safety of service users in their care EVIDENCE: The recruitment of staff in Eastside house is undertaken thoroughly. This ensures that service users are in safe hands of those employed to work in the home. All checks are carried out such as written references and criminal records checks. The district nurse was visiting at the time of inspection and stated that, “ I have no concerns regarding the quality of care here, this is one of my best homes, the service users are very happy and there are never any complaints”. Currently the home has six staff completing their NVQ. Following difficulties with identifying an assessor for staff, this has been overcome and staff are now getting their work assessed. Three staff spoken to stated that they are well supported in the home with training and things are fine there. Two staff are being supported by the home to improve their written and spoken English prior to starting the NVQ. The home has forthcoming training in Food Hygiene, First Aid, and Record Keeping. Eastside House Rest Home DS0000010403.V259201.R01.S.doc Version 5.0 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,38 A caring committed manager runs Eastside house. The home does not fully meet the health and safety of service users due to a lack of night fire drills and a detailed fire evacuation plan. EVIDENCE: The manager of the home is very committed to providing good quality care to service users and a learning environment to staff. The manager shares information with staff relating to good practice. Evidence on care plans show that the manager looks at plans and tries to address with staff where there are shortfalls. The issue is that staff do not always correct any deficits which result in care plans not being adequately detailed. Staff must take responsibility for completing these properly. This was discussed with staff during inspection. The effect of detailed care plans is that service users could be fully supported by Eastside House Rest Home DS0000010403.V259201.R01.S.doc Version 5.0 Page 16 any staff because the detail pertaining to their care will be evident and deterioration and progress can be adequately monitored. The policies and procedures in the home have not all been reviewed as required in the previous inspection. Whilst this is partially met those outstanding must be completed. The relatives undertake the finances of service users. The home does not administer finances for any individuals. The home completes and records fire tests and drills. However the home does not complete night fire drills. This must be done to ensure night staff know how to respond in the event of an emergency at night when less staff are available. The home has a fire action procedure in place, however this is too basic and does not state what staff should do in respect of service users should there be an emergency. This needs to be revised to ensure that staff are clear of their responsibilities in this situation. The home resealed the wall around the cooker as required in the previous inspection. The recommendation to use liquid soap and paper towels in the toilets has been taken up by the home to minimise any spread of infection. Eastside House Rest Home DS0000010403.V259201.R01.S.doc Version 5.0 Page 17 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 X X 2 Eastside House Rest Home DS0000010403.V259201.R01.S.doc Version 5.0 Page 18 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 OP7 Regulation 15(1)(2) (a,b,c&d) Requirement The registered person must ensure that staff complete care plans in detail and record what actions will be taken and how they will be achieved. (Previous timescale 31/07/05 not met) The registered person must ensure that written procedures are in place for staff when dealing with accidents. To prevent any delay in care or treatment provided. This must be done in consultation with relevant health professionals such as GP’s or district nurses. This procedure must be forwarded to the commission. The registered person must ensure that all staff sign at the time medication is administered. Staff must also maintain records of all communication with the pharmacy when medication is incorrectly dispensed to the home. The registered person must complete its review of the policies and procedures in the home. (Previous timescale DS0000010403.V259201.R01.S.doc Timescale for action 01/02/06 2 OP8 12(1)(b) 29/12/05 3 OP9 13(2) 10/12/05 4 OP33 17(20) 3(a&b) 01/02/06 Eastside House Rest Home Version 5.0 Page 19 5 6 OP38 OP38 23(4)(e) 23(4) (a&c) 30/06/05 not met) The registered person must ensure that night fire drills are undertaken and recorded. The registered person must amend the fire action procedure to include what action staff must take in respect of service users. On completion, a copy of the amended actions must be forwarded to the commission. 29/12/05 03/01/06 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 Eastside House Rest Home DS0000010403.V259201.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Eastside House Rest Home DS0000010403.V259201.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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