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Inspection on 14/07/05 for Edwina House

Also see our care home review for Edwina House for more information

This inspection was carried out on 14th July 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People living at the home where generally happy with the care provided. They said that the staff understood and knew how to meet their needs. People who live at the home are provided with information on the service provided by the home. People living at the home are supported by staff who understand their needs. Service users live in a home that is safe.

What has improved since the last inspection?

Of the ten areas for improvement identified at the last inspection nine were found to have been addressed. The management of the home has put in place ways of assessing and planning the support of those who have dementia. The information on the needs of service users has been updated to include more detail on meeting the needs of people living at the home. Tissue viability support was identified. Information on the needs of those living at the home had been reviewed weekly. Medicines are stored at the required temperature.

What the care home could do better:

Nine areas for improvement were identified at this inspection. There is a need for falls risk assessments to be put in place. Records of turning of those living at the home needs to be recorded in more detail. The manager must confirm that all nursing staff are trained to give medication. Service users said that they felt bored and needed more activities. The bedrooms of those living at the home need to have new armchairs. Staff must receive training on care planning and the national vocational qualification in care. The registered manager of the home needs to confirm that all staff have the necessary statutory training. There are gaps in the information relating to the recruitment of staff.

CARE HOMES FOR OLDER PEOPLE EDWINA HOUSE 64-66 Grovelands Road Palmers Green London N13 4RJ Lead Inspector Tony Brennan Announced 14 July 2005 10.00 am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. EDWINA HOUSE Version 1.10 Page 3 SERVICE INFORMATION Name of service Edwina House Address 64-66 Grovelands Road, Palmers Green, London N13 4RJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8886 6658 020 8882 6265 Sooreedeo & Elizabeth Hurree Sooreedeo Hurree N Care Home with Nursing 22 beds Category(ies) of PD - Physical Disability registration, with number DE - Dementia of places OP - Old Age A - Alcohol Dependency past/present EDWINA HOUSE Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1 Where service users are admitted only for intermediate care, dedicated accommodation is provided. Date of last inspection 3 August 2004 Brief Description of the Service: Edwina House is owned and managed by Mr. Sooreeado Hurree and Mrs. Elizabeth Hurree. The home is registered to care for twenty-two service users. The home comprises of two semi-detached two storey houses, which are joined and extended. There are fourteen single and four double bedrooms. There are two communal areas for sitting and dining. The home has a passenger lift and stairs to the second floor. There is a garden to the rear of the property. The home is situated within walking distance of Palmers Green station and there is a regular bus service. The home is close to local shops and amenities. The home aims to provide a caring environment for the service users who live there. EDWINA HOUSE Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken as part of the annual inspection process. The inspector also sought to confirm that the ten areas for improvement found at the last inspection were addressed. The inspection took place over one day. The inspector spoke with five service users and four staff. The inspector also spent time observing the care being given as a number of the people living in the home have communication difficulties. The inspector toured the building and examined a range of records relating to the care and management of the home. What the service does well: 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. EDWINA HOUSE Version 1.10 Page 6 The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. EDWINA HOUSE Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection EDWINA HOUSE Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 3 4 Service users and prospective service users are provided with comprehensive information about the service. Service users needs are assessed prior to admission to the home. Service users needs are met. EVIDENCE: The inspector spoke to a service user who said that they had been given information on the home before admission. The statement of purpose and service users guide provided clearly written and detailed information on the home. A service user spoken to said that staff had discussed her needs with her prior to entering the home. The inspector found that files seen had an assessment from the home as well as assessments from health professionals and social workers. Service users spoken to said that they felt the staff were caring and understood their needs. There were assessments and care planning was in place. EDWINA HOUSE Version 1.10 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 8 9 Care plans provided detailed information on how the needs of service users would be met. The medical needs of service users are not being met. Service users are not protected by safe procedures for handling medication. EVIDENCE: Service users said that they felt that staff understood the help and support they needed. Since the last inspection the care plans had been updated so that more information on the needs of service users is available. This included providing information on the needs of those service users with dementia. Care plans are now being reviewed monthly. The inspector found that there were assessments and care plans of service users susceptibility of developing pressure sores. The treatment required was explained. The inspector found that the record of turning did not provide detailed information on when service users had been turned. The registered person agreed to ensure that more information on when and how turning occurred was recorded. There was no falls assessment or prevention plan in place even through records showed that service users had had falls. The records of medicines received, administered and returned were complete. The policy was complete. Staff had received training, but three nurses had not received training at the home. This was discussed with the registered manager EDWINA HOUSE Version 1.10 Page 10 who agreed to confirm that they were trained to administer medicines. Arrangements had been made to return medication to Boots for safe disposal. EDWINA HOUSE Version 1.10 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 standard(s) 12 15 Service users are not provided with varied activities that met their personal preferences and needs. Service users are provided with a choice of varied and balanced meals. EVIDENCE: Service users explained that they do listen to music, but generally they felt that there was nothing to do. On the day of the inspection no activities took place. There needs to be more varied activities offered which reflect the service users interests. Service users spoken to said that a choice of meals was offered and that generally the food was of a good quality. The menu was found to offer a balanced diet. The inspector sat with service users at lunchtime and observed that a well presented meal was provided for each individual. Service users needing support with eating were assisted. EDWINA HOUSE Version 1.10 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 standard(s) 16 18 Service users are confident that their complaints will be listened to, taken seriously and acted upon. Service users are protected from abuse. EVIDENCE: Service users said that they felt confident in making their concerns known to staff. The complaints policy explained how to make a complaint and how it would be dealt with. Service users said that they felt safe and could approach staff if they had any concerns regarding how they are treated. There were comprehensive policies on handling abuse and protection. Staff spoken to were clear about the signs of abuse and how suspected abuse should be handled. Records showed that staff had received training on adult protection and further training is planned. EDWINA HOUSE Version 1.10 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 standard(s) 21 24 26 Service users are able to access bathroom and toilet facilities that meet their needs. Service users bedrooms did not contain all the items of furniture to make them homely and attractive. Service users live in a clean and hygienic home. EVIDENCE: The inspector saw that since the last inspection all wheelchairs had been removed from the downstairs assisted bathroom and toilet. The bedrooms seen were personalised. The armchairs in the bedrooms are worn and in need of replacement. The inspector found that the home was clean and hygienic. Staff spoken to understood how to prevent cross infection and equipment was provided for this purpose. EDWINA HOUSE Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 28 29 30 Sufficient staff are available at all times to meet service users needs. Staff do not have all the skills and knowledge to meet the needs of service users. Service users are not fully protected by the home’s recruitment practices. EVIDENCE: Service users said that there were enough staff available to meet their needs. Staff also felt that they had sufficient staff with five working in the morning and four in the afternoon. The inspector found that six staff are currently doing NVQ in care at level 2. The home still needs to ensure that 50 of staff obtain this qualification. From the records it was not possible to confirm that all staff had received the required statutory training. The records did not show the necessary certificates to confirm that training had been given. The inspector found that staff still need to have training in care planning. The inspector checked four staff files and found that not all documents relating to recruitment were available. Two files contained CRBs from previous employers and one had only one reference. The files of two qualified staff were checked and it was found that their professional registration was out of date. The registered manager said that he would ensure that this was dealt with. EDWINA HOUSE Version 1.10 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 37 38 Staff are appropriately supervised to ensure the safety of service users. Records are not maintained as is required. Service users and staff health and safety is promoted at all times. EVIDENCE: Staff spoken to said that they had had regular supervision. The inspector found that records of supervision showed that supervision is taking place six times a year. All the records required were in place and appropriately stored. The inspector found that a number of records were not organised so that information was easy to access. The inspector discussed this with the registered manager and recommended that a review of the organisation of records be carried out. The necessary records of food temperatures and of the fridge and freezers had been maintained. Gas and electrical certificates were seen and in date. The boiler has been replaced. Fire records were checked and showed that drills and testing was ongoing. The necessary maintenance checks were being carried out on the fire alarms and equipment. The home EDWINA HOUSE Version 1.10 Page 16 had all the necessary policies and procedures in place to ensure the safety of service users and staff. There was a record of accidents in place. EDWINA HOUSE Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x x 3 x x 2 x 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x 3 3 3 EDWINA HOUSE Version 1.10 Page 18 yes Are there any outstanding requirements from the last inspection? 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 8 Regulation 13 Requirement The registered persons must ensure that there is a falls risk assessment and care plan in place for service users. The registered persons must ensure that there is a full record of how and when service users with tissue viability are turned. The registered persons must confirm that all staff administering medication have appropriate training from a pharmacist. The registered persons must ensure that there is a programme of activities that meets the needs of service users. The registered persons must ensure that the arm chairs in service users bedrooms are replaced. The registered persons must ensure that 50 of staff achieve NVQ in care at level 2. The registered persons must ensure that all the documentation relating to recruitment is obtained prior to new staff starting at the home. The registered persons must Version 1.10 Timescale for action 1/10/05 2. 8 13 1/9/05 3. 9 13(2) 15/8/05 4. 12 12 1/9/05 5. 24 16 1/12/05 6. 7. 28 29 18(2) 19 31/12/05 1/9/05 8. 29 19 1/10/05 Page 19 EDWINA HOUSE 9. 30 18(2) 10. 30 18(2) ensure that all nursing qualified staff have an up to date professional registration. The registered persons must 1/9/05 ensure that staff are trained in care planning. ( The previous date of the 1/10/04 was not met. A new date is set). The registered persons must 1/10/05 ensure that all staff have had the required statutory training. 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 36 Good Practice Recommendations The registered persons should ensure that all records are well organised. EDWINA HOUSE Version 1.10 Page 20 Commission for Social Care Inspection 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 EDWINA HOUSE Version 1.10 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. 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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