Inspection on 25/10/05 for Ganarew House

This inspection was carried out on 25th October 2005.

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

Ganarew House 18/12/08

Ganarew House 05/12/07

Ganarew House 23/01/07

Ganarew House 05/09/06

Ganarew House 08/02/06

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

CARE HOMES FOR OLDER PEOPLE Ganarew House Ganarew Near Monmouth Monmouthshire NP25 3SS Lead Inspector Denise Reynolds Announced Inspection 25th October 2005 10:00 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 Ganarew House DS0000065335.V265489.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. Ganarew House DS0000065335.V265489.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ganarew House Address Ganarew Near Monmouth Monmouthshire NP25 3SS 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) 01630 890273 Milkwood Care Limited Care Home 15 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (15) of places Ganarew House DS0000065335.V265489.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. A Statement of Purpose, Service User Guide and complaints procedure specific to Ganarew House will be submitted to CSCI within one month of the date of registration. If the last electrical installation certificate is more than 5 years old an inspection of the electrical wiring by an NICEIC or ECA authorised engineer will be commissioned within three months of registration and remedial work prioritised and carried out as indicated by the engineer`s report . Except where urgent work is identified this will be done in conjunction with the planned construction work. Until a manager is appointed by Milkwood Care Ltd and registered by CSCI, Janet Lloyd-Leech (Responsible Individual) and Marion Flett (Group Manager) will between them spend a minimum of 30 hours a week at Ganarew House. O8/03/05 2. 3. Date of last inspection Brief Description of the Service: Ganarew House is a converted country house in a rural hamlet between the towns of Ross on Wye and Monmouth. The setting is very attractive with views over open countryside and large gardens. The Provider, Milkwood Care Ltd took over the Home on 4th October 2005 from the previous owners who had run the Home for over 15 years. The Provider is registered in respect of the Home to provide care for up to 15 people with care needs relating to the ageing process or the effects of having a dementia illness. The new Providers have obtained planning consent for an extension to the premises which will increase the number of people that can be accommodated. Ganarew House DS0000065335.V265489.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place only 3 weeks after the Home had changed ownership and for this reason priority was given to speaking to residents, staff and the new owners about how they felt things were going and how people were feeling about the change of ownership and management. CSCI comment cards for residents and relatives were left at the Home for distribution with a view to the responses contributing to the planning of the next inspection and the subsequent report. During the inspection the new management team met with the inspector to describe their initial priorities and provide information about progress towards meeting the additional conditions of registration. The inspector spoke with one new resident in her room and met with 8 of the residents in the sitting room. The information in this report is substantially based on the information gathered from these discussions. What the service does well: What has improved since the last inspection? The last inspection was carried out under the previous ownership. The Home already provided a friendly place to live with a good standard of care. However, after many years as a care provider, the previous Provider/Manager felt that the time had come to pass the Home to a larger organisation with the resources to provide the Home with a secure future and to address current expectations as outlined in the National Minimum Standards. Ganarew House DS0000065335.V265489.R01.S.doc Version 5.0 Page 6 The new Provider has already made progress towards doing this. A more comprehensive care plan format has been introduced and short-term improvements have been made to the fabric of the building and to the furnishings. An extension to the building is also planned. Plans are being made for staff training to be established on a stronger footing and a new medication system is being introduced. 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. Ganarew House DS0000065335.V265489.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 Ganarew House DS0000065335.V265489.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): 1, 3 Detailed information about the Home has been produced so that prospective residents and their relatives can use it to help them decide if they wish to move to Ganarew House. An assessment format has been introduced to ensure that the Home has enough information about a person to be sure they can provide the care needed. EVIDENCE: A new Statement of Purpose and Service User Guide have been produced thereby meeting an additional condition of registration regarding this. The documents are written in a clear, easy to read and welcoming tone. The new manager designate has introduced the assessment format used by the Company at its other care homes. This is a comprehensive document covering all the expected areas. This format had been used for the one person who had moved in since the change of owner. The information that had been gathered was still being added to bey staff as they got to know the person. By speaking to the resident concerned it was established that she was very satisfied with her first few days at the Home and felt that staff were giving her the help she needs. Ganarew House DS0000065335.V265489.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): 7,8,9,10 The new management supported by existing staff are conscientious in providing individualised and attentive care so that residents’ care needs are attended to. EVIDENCE: Residents spoken to were full of praise for the staff and very pleased with the first impressions they have of the new management team. The six resident comment cards already received indicate satisfaction with the service provided by the Home. The new management team were similarly positive in their view of the staff team at the Home stating that the care practice they have found is ‘very good’. All of the care records have been changed over to the organisations care planning format and staff confirmed that they have been fully consulted and involved in this. Observation of staff contact with residents, supported by the positive things the residents said confirmed that people living at Ganarew House are treated respectfully and with warmth and affection. Arrangements were in hand to change the medication arrangements at the Home and to provide training for staff in this important area. The Ganarew House DS0000065335.V265489.R01.S.doc Version 5.0 Page 10 management team were confident that they are already well down the road of meeting all the requirements from the CSCI pharmacy inspection in July. All the staff spoken to had been present for the first day of mediaction training and were aware that this was to be followed with more training when the new system is introduced. Ganarew House DS0000065335.V265489.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): 13,14 Staff work hard to provide a friendly and welcoming home for residents and their visitors. The plans of the new owners look set to enhance this by the provision of improved facilities. EVIDENCE: Discussions with residents and staff confirmed that the general happy and relaxed atmosphere at Ganarew House has been unchanged by the recent change of ownership. Residents understood the decision of the previous owners to leave and wished them nothing but happiness for the future. They spoke of being reassured by the willingness of the new management team to explain their plans and to ask for their views and opinions. They said that their visitors are still made as welcome as always and that staff still take the time to talk to them. They have been pleased to be involved in some day to day decisions. For example they were consulted about the removal of a rug from the sitting room floor to avoid someone tripping. They told the inspector they had readily agreed because it made a change to the look of the room. Residents were also pleased that a modern, flat screen TV set has been ordered for the sitting room. They feel that this will be an improvement because it is going to be larger than the current one and will help those of them with poor eyesight. Ganarew House DS0000065335.V265489.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): These standards were not inspected. EVIDENCE: Ganarew House DS0000065335.V265489.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 physical environment is very homely; the planned refurbishment and extension should significantly enhance the standard of accommodation for the residents and improve the working environment for staff. EVIDENCE: Everyone spoken to gave examples of the short term improvements being made in the house – for example, the residents were very amused by the fully laden skip that had been used to throw away furniture past its best – especially as they had been asked for their opinions about what should go in it. A number of carpets have been cleaned. Plans are being made to replace much of the furniture at the Home to comply with modern fire safety legislation and new curtains and décor is planned for the communal rooms. A full time maintenance man has been employed to start work at the end of October and a maintenance book and improvements list introduced. Ganarew House DS0000065335.V265489.R01.S.doc Version 5.0 Page 14 Work on a new staff sleeping in room and an additional ensuite bedroom for a resident is due to start in advance of the main new build extension. Residents were aware of these plans and have been told that they will be shown the plans for this soon. As part of the upgrading the kitchen will be refurbished and the cook has been involved in discussions about design. The plan to create an area where more able residents can make a cup of tea is very positive. A service agreement for the collection of clinical waste has been arranged and laundry trolleys and bags provided for the transport of linen and clothing to the laundry. Staff had identified a problem with the call system not being audible on the top floor and a new sounder had been fitted in response. An electrical safety report had been commissioned and the Provider was making arrangements for the work identified to be carried out. When completed this will address the second additional condition of registration. It was noted that a first floor bedroom window could be opened very wide. The Provider and Inspector identified this on the day of the inspection. The resident in that room was not seen as being at risk of falling but the manager designate said she would carry out a risk assessment and record the outcome that day. This highlighted a need to check all the windows and to carry out risk assessments. Ganarew House DS0000065335.V265489.R01.S.doc Version 5.0 Page 15 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): 27,28,30 There is a well established staff team who work well as a team. A good relationship has been established with the new Provider and management team; this has minimised the anxiety of recent changes for the residents who still feel safe and well cared for. The planned investment in staff training will further enhance the competence of the staff. EVIDENCE: Staffing arrangements were not inspected in great detail but from discussion with residents and staff there was evidence of good outcomes for residents already and enthusiasm about the future. The core staffing levels on the day of the inspection and appeared sufficient for the needs of the current residents. Staff spoke of plans for them to do NVQ training and were enthusiastic about this. Ganarew House DS0000065335.V265489.R01.S.doc Version 5.0 Page 16 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): 32,33 The consideration given to the anxieties and views of residents by the new Provider and management team during this initial period provides a positive impression of their intentions for the way the service is to be managed in the future. EVIDENCE: Throughout this inspection the care and attention paid to minimising the effect on the change of ownership on the residents was apparent. This impression was reinforced by what the residents and staff had to say. It was also positive that the residents knew the four member of the management team already and spoke about them in a relaxed way. One resident joked about how many of them there are but that they all seem to be very busy all the time. The residents said they are pleased the Home is going to stay open and think the new owners ‘are making a good job of it – and it’s only early days yet’. Ganarew House DS0000065335.V265489.R01.S.doc Version 5.0 Page 17 The only concern raised was a hiccup in having the Sunday papers delivered – the Responsible Individual was already aware of this and looking to solve the difficulty. The minutes of a staff meeting provided further evidence of an open, consultative style of management and a willingness to act on the views of staff. The Responsible Individual and the Organisation’s Group Manager are both spending time at the Home to support the Manager Designate as agreed in the third additional condition of registration. The Organisation has a structured Quality Assurance programme and will be introducing this at Ganarew in the coming months. Ganarew House DS0000065335.V265489.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x N/A 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 x 13 3 14 3 15 x 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 3 28 3 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 3 x x x x x Ganarew House DS0000065335.V265489.R01.S.doc Version 5.0 Page 19 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 OP19 Regulation 13 Requirement All windows must be checked and a risk assessment carried out to establish which need to be fitted with devices to prevent them opening too widely. Timescale for action 30/11/05 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 Ganarew House DS0000065335.V265489.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN 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 Ganarew House DS0000065335.V265489.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. 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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