Inspection on 21/08/07 for Galsworthy House Nursing Home

This inspection was carried out on 21st August 2007.

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

Galsworthy House Nursing Home 14/08/06

Galsworthy House Nursing Home 19/12/05

Galsworthy House Nursing Home 25/07/05

Galsworthy House Nursing Home 25/01/05

Galsworthy House Nursing Home 10/08/04

Galsworthy House Nursing Home 27/02/04

Galsworthy House Nursing Home 02/12/03

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

CARE HOMES FOR OLDER PEOPLE Galsworthy House Nursing Home 177 Kingston Hill Kingston Surrey KT2 7LX Lead Inspector Jon Fry Key Unannounced Inspection 21st August and 6th September 2007 10:20 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 Galsworthy House Nursing Home DS0000026245.V348692.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. Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Galsworthy House Nursing Home Address 177 Kingston Hill Kingston Surrey KT2 7LX 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) 0208 547 2640 0208 547 3175 www.slnh.co.uk South London Nursing Homes Limited Mrs Catherine Mary Robertson Care Home 72 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0), of places Physical disability over 65 years of age (0), Terminally ill over 65 years of age (0) Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th August 2006 Brief Description of the Service: Galsworthy House provides nursing care for up to 72 older people. It also provides care to older people who may have a terminal illness, dementia and / or a physical disability. The home is situated in a pleasant residential area of Kingston. Accommodation is provided over three floors in a listed building that has been thoughtfully extended. The majority of rooms are single and some have the attraction of overlooking Richmond Park. The home has two lifts. Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We spent thirteen hours in the home over two separate visits. We spoke to eleven people who live at the home, the manager and six staff members. We looked at records and documents, including three people’s care plans and the home’s User Guide. Completed surveys were received from five people living at the service, one relative or friend of an individual and two healthcare professionals. The home completed an Annual Quality Assurance Assessment (AQAA) to tell us about the service provided, how it makes sure of good outcomes for the people using it and any future developments being planned. What the service does well: What has improved since the last inspection? Medication administration records are completed well and kept up to date. Complaints records are kept better. Staff access to training continues to develop and improve. A full audit around person centred care by an external company has taken place. Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Galsworthy House Nursing Home DS0000026245.V348692.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 Galsworthy House Nursing Home DS0000026245.V348692.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): 1, 2, 3 and 4. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information is available about the home to help people make a choice about living there. Assessments are completed before people move in and these are kept under review. EVIDENCE: “On the whole very good”, “overall excellent”, “I’m quite pleased” and “I’m quite happy here” were some typical comments from people living at the home. We saw that a guide is available which tells people about the home and the service it offers. This is currently only available in normal type and we have recommended that it be made available in other formats such as large print, pictures and audiotape. When someone comes to live at the home, they are Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 Page 9 provided with a contract. This is included in the guide and should also be looked at to make sure it is easy to understand and available in alternative formats. In completed surveys, 100 of the people who use the service said that they had received enough information to make a decision about moving in. One person said that their relative had come to look and “was happy with what she saw”. Assessments had been completed for two people who had recently come to live there. These recorded some good information about physical needs but could be improved to be more person centred and capture more detailed information about the persons background and their likes and dislikes. This may help staff to plan the care better and tailor the service provided much more to the individual. We think that the home should also consider giving a questionnaire to the person or their representative to ask them about their life and how they like to live it. Galsworthy House Nursing Home DS0000026245.V348692.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 and 10. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans look at the health, personal and social care needs of individuals but need to be improved to be even more person centred. Arrangements for the handling, storage and administration of medication are adequate. The health needs of individuals are addressed well by the home. EVIDENCE: People we spoke to said that staff treated them with dignity and respect. Comments included “always polite” and “the staff actually care”. 60 of people who completed surveys said ‘always’ when asked if they received the care and support they needed. 40 said ‘usually’. We looked at the care plans for three people. Each care plan sets out how their needs are to be met and this document is reviewed regularly. The plans Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 Page 11 could be improved to contain more individualised information to help staff deliver person centred care. We did see some good detail recorded about the person but this tended to be mainly about their health and physical care. Many actions recorded were however still too generalised such as ‘ensure personal hygiene is given’ or ‘give oral hygiene’. The manager explained that the care plans were being transferred to a new computerised system and many still needed development. Care staff need to make sure that good quality and specific person centred information is recorded for everyone who lives there. For example when looking at personal care needs, does the person like a bath or a shower, which bathroom do they use, what day or time do they prefer and who do they like to help them? As stated previously capturing good information in the assessments carried out when the person first comes to live at the home can help with care planning. It is important that good background and life history information is recorded particularly for people with dementia as it may aid staff in communicating and ‘reflecting back’ to the individual. The information we saw was very brief and some of this was not specific enough. For example, lacking the names of children or grandchildren that may be needed by staff when talking with people or to help them remember. Care plans around ‘expressing sexuality’ referred to individuals liking to dress smartly or to look nice. It is recommended that the staff team discuss this area further and decide what information should be recorded. Daily notes kept by staff should also be looked at to make sure that good quality useful information is recorded. We saw that some notes tended to be repetitive and made general statements – ‘comfortable morning’ and ‘appears content and comfortable’. The health needs of individuals are met well. We saw that people can see a GP who regularly visits the home. A dietician was present at the home on the second day we visited, records seen showed that individuals can see other healthcare professionals such as a physiotherapist or optician when they need to. Risk assessments are completed well for areas such as pressure areas and nutrition. We saw that these were kept under review. Both health professionals who completed surveys felt the home ‘always’ managed peoples health needs well. One person said “very good overall” and the other individual commented “people are always well dressed, clean and comfortable”. Staff administer medication to people living there safely and keep accurate records of this. There were a number of instances where quantities of medication were difficult to audit accurately from the records kept. This was discussed with the managers and we saw that steps had been taken to solve this problem on our second day of inspection. Galsworthy House Nursing Home DS0000026245.V348692.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 and 15. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers a good range of activities. There is scope to improve this by making sure there is a full social care plan for each person and involving all staff in delivering this care. Improvements need to be made to make sure that mealtimes are a positive occasion for everybody involved. EVIDENCE: Most people spoken with said that they enjoyed the food offered with comments including “very good”, “not bad”, “it’s very good now” and “there’s nothing wrong with it”. One person said that the meals “institutional but good” and another individual said “standard but perfectly satisfactory”. People spoken to said they were given a choice of meals and could eat in their rooms if they wanted to. Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 Page 13 We looked at lunch being served on all three floors during our visits. The service needs to look at how mealtimes can be made a more positive social occasion throughout the home and an opportunity for people to talk and interact. This is particularly important on the two upper floors where people need more time and intensive support from care staff. Staff need to review when and how the meals are served particularly when lots of people need assistance to eat. We saw instances of staff standing when supporting individuals to eat and staff members helping two people at the same time. It is recommended that the menus be presented in more user-friendly ways such as large print or pictures to help some people make choices. There is a good range of activities on offer to people living there. The home has one activities co-ordinator who is employed for 30 hours per week. There was a vacancy for another activities co-ordinator at the time we visited. A weekly schedule is displayed throughout the home. Activities include coffee and exercise, visiting entertainers, quizzes and gardening. Trips are arranged outside of the home each month and speakers invited to give talks on a variety of subjects. We saw a well attended talk being given on 20th Century Glass on the second day of our inspection. Comments from people living at the home included “they have a few things going on”, “there’s enough going on”, “there are trips” and “I get out in the garden”. One person spoke very positively about a recent trip to Brooklands Museum which they had obviously enjoyed very much. Care staff spoken to said that they did not routinely provide activities and said that this was not really their role. We saw a number of instances where people were sitting in the upper floor lounges but staff did not seem to have time to chat or interact with them. We have strongly recommended that the home look at how care staff could be actively involved in the provision of activities. This may involve reviewing individual roles, shift patterns and established routines but this may be important in developing care that is person centred rather than task based. Staff spoken to clearly had a good knowledge about what person centred care is but seemed to be needing more support in putting this into practice. Staff also reported that many people needed high levels of help with personal care each day that did not allow them much time to interact with people. One staff member said they would “like more time to sit and chat” with people during their shift and another person said “our schedule does not allow for this”. The organisation should look at providing the home with its own transport to use. This will support more trips out for individuals and allow more spontaneity as the weather allows. Galsworthy House Nursing Home DS0000026245.V348692.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 and 18. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are protected from abuse. Concerns about the care provided are listened to and acted upon. EVIDENCE: Comments from people who live at the home included “no complaints”,“ I never grumble” and “any problems are dealt with”. Individuals spoken to said they felt able to speak to staff or managers about any issues they may have. 100 of the people who completed surveys said that they knew how to make a complaint. Records are kept of any concerns or complaints received and we saw that these were well maintained. These showed that action had been taken in response to issues raised both verbally or in writing by people living there or their representatives. The complaints policy and procedure is displayed in the home and is part of the guide for the people living there. The home should look at making sure that the complaints procedure is available in different formats as appropriate. Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 Page 15 Care staff have mandatory training that teaches them how to recognise and report abuse. There is an organisational procedure for staff to follow in the event of any allegations being made. Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 Page 16 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, 24 and 26. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, comfortable and well maintained. Bedrooms are personalised and feel very homely. EVIDENCE: People spoken to were happy with the environment. Comments from individuals included “a nice room with a good outlook”, “fine”, “light and airy”, “a very pleasant room” and “comfortable”. We saw that the home generally provides a very pleasant, comfortable and well maintained place for people to live. Bedrooms seen were all personalised to the individual with many containing peoples own furniture and pictures. The ground floor has very spacious communal lounges and access to garden areas with plenty of seating. Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 Page 17 The home was very clean and hygienic on both days we visited. Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are generally enough staff on duty to meet the needs of people using the service and individuals are happy with the care they receive. There is a good staff training and development programme in place. EVIDENCE: Feedback about the way the staff carried out their duties was generally positive. Comments included “enough around, “excellent”, “polite” and “all the people are kind”. Two people felt that communication could be an issue at times with care staff coming from different cultures. We saw that staff were caring and spoke to individuals in a polite and respectful manner. Care staff we spoke to had a good understanding of what person centred care is and some were completing dementia training at the time we visited. 40 of people who filled in surveys said that staff were ‘always’ available when needed. 40 of individuals responded ’usually’ and 20 said ‘sometimes’. We saw that care staff were very busy and needed to spend a lot of time with people in their rooms to support them with things like toileting, Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 Page 19 washing and dressing. This makes it seem like there are not many staff around at times. As stated previously, there is scope to look at the role of carers and make sure that social and emotional care is seen as an important part of their job. We have recommended that the home looks at individual roles, shift patterns and established routines to help support person centred care. It is recommended that staff teams also look at the routines in place on each individual floor to see if there are areas where they could move away from task based care to a more person led approach. Changes in culture may require further training and support ‘out on the floor’ from the organisation and the training manager we spoke to said that this was already part of their plans in the coming months. Staff have access to a very good programme of training. Mandatory training is provided in a number of topics such as safeguarding adults, manual handling and Health and Safety. Additional workshops are provided on specialist areas and there is very strong NVQ provision with staff able to study for both the Level Two and Three qualifications. Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 Page 20 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, 32, 33, 35, 36 and 38. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is well run. There are generally good arrangements to make sure that the health and welfare of people using the service is protected. EVIDENCE: The manager has considerable knowledge and experience of running a care service for older people. Comments from staff about the management of the home included “very understanding” and “very good support”. We saw that there were enough senior staff in place but further thought could be given to their role and individual ability to lead care staff on each floor. Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 Page 21 Care staff need to have someone leading the shift and role modelling good practice for them to follow. We did not clearly see this happening and think that that improvements in this area may help support good person centred care within the service. This could also link with the planned training support being given to staff when out on the floor. Staff spoken to said that they are receiving formal supervision with their line manager and these sessions are becoming more regular. A formal quality management system is operated at the home to regularly look at all areas of the service. A full external audit had recently taken place to look person centred care within the home and the management were looking at the results of this at the time we visited. There are currently no meetings for people living at the home and we were told that this consultation was done informally on a day to day basis. We saw lots of examples of individuals, their relatives or friends talking with staff and being kept up to date. There may be scope to develop other ways in which the people living there could be more formally involved in the running of the home. This may be through meetings, development of a user committee or representation at management meetings. Health and Safety checks take place to make sure people are kept safe and generally good records are kept of these. We have made a Requirement for the home to monitor and record the temperatures of fridges kept on each floor. It is strongly recommended that the hot water temperatures of baths and showers be recorded each week rather than on a monthly basis. Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 Page 22 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 3 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X 4 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 3 3 X 3 3 X 3 Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP15 Regulation 12 (4) (5) Requirement Timescale for action 01/12/07 2. OP38 13 (4) Mealtimes need to be reviewed to make sure they are a positive occasion for the individuals living there. This is with regard to ensuring there are always adequate numbers of staff available to assist individuals and looking at the way people receive this assistance. In order to protect the safety of 01/10/07 people living at the home, weekly checks must be made of hot water temperatures of all baths and showers with records kept. Daily records of fridge temperatures on each floor must also be kept. Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 Page 24 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. 2. 3. Refer to Standard OP1 OP2 OP3 Good Practice Recommendations The user guide to the home should be made available in a variety of formats such as large print, audiotape or pictures. It is recommended that the home looks at making sure that contracts are in plain English and supplied in alternative formats as required. The assessment format should be reviewed to make sure that good quality person centred information is captured. This can then be used to inform the care plan from when the individual moves in. The home should look at ways to make the care plans more person centred and better reflect the individual’s life and preferences. The plan in place should direct the care to be person orientated and less task based. Care plans need to give specific information about how the person likes the care and support to be delivered. Better background information about the person and their life should be recorded. Daily notes need to be reviewed to make sure that good quality useful information is being recorded. Systems in place for the handling and administration of medication need to be reviewed. This is to make sure that people living at the home always receive their prescribed medication and that quantities of medication can be easily checked to ensure this. The home should look at how care staff can be more involved with the provision of social activities. The organisation should also continue to try to recruit an additional activities co-ordinator. It is strongly recommended that further training courses be made available to the activities co-ordinator(s). It is strongly recommended that the home have its own minibus or similar vehicle available. Mealtimes should be made a more positive occasion and an opportunity for people to interact. Practices such as protected mealtimes, varying numbers / times of meals, DS0000026245.V348692.R01.S.doc Version 5.2 Page 25 4. OP7 5. 6. OP7 OP9 7. OP12 8. 9. OP12 OP15 Galsworthy House Nursing Home 10. 11. 12. OP27 OP30 OP32 13. OP33 and staff eating with people who live there should be seriously considered by the home. It is strongly recommended that the home looks at staffing roles, shift patterns and routines in place to help support person centred care throughout the service. The home should look at how care staff can be trained and supported whilst on shift to develop practice that is person centred rather than task based. The role of senior staff on each floor should be reviewed. This is to make sure that staff always have someone who is leading their shift and role modelling good practice for them. It is recommended that the home look at developing other systems for consultation with people living at the home. These may include meetings, a user committee or representation at management meetings. Galsworthy House Nursing Home DS0000026245.V348692.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Galsworthy House Nursing Home DS0000026245.V348692.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!