Inspection on 19/06/06 for Gardenia House

This inspection was carried out on 19th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Gardenia House 14/02/06

Gardenia House 09/09/05

Gardenia House 10/01/05

Gardenia House 07/09/04

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

CARE HOMES FOR OLDER PEOPLE Gardenia House 19 Pilgrims Court Farnol Road Dartford Kent DA1 5LZ Lead Inspector Ruth Burnham Key Unannounced Inspection 19th June 2006 09:30 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 Gardenia House DS0000023943.V299322.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. Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gardenia House Address 19 Pilgrims Court Farnol Road Dartford Kent DA1 5LZ 01322 290837 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) Heritage Care Limited Mr Nigel Odd Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (23), Physical disability (1), Physical disability of places over 65 years of age (1) Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Care for people with physical disabilities is restricted to one resident whose date of birth is 11/06/1936. Care for 1 older person with physical disabilities is restricted to a person whose d.o.b. is 21/06/1934. 14th February 2006 Date of last inspection Brief Description of the Service: Gardenia House is owned by English Churches and managed by Heritage Care Limited. It provides residential care for up to 25 people over the age of 65. All bedrooms are single and have en-suite facilities some have en-suite showers. Bedrooms are situated over three levels, which are accessed by a shaft lift. The home is situated on the outskirts of Dartford, relatively close to bus and train services and local amenities. There is a small, open, garden area to the rear, an enclosed garden area to the side and limited parking facilities at the front of the home. Fees start at £389.00 per week. Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by Ruth Burnham, Regulatory Inspector on Monday 19th February 2006 between 9am and 3:30pm. Judgements are based on conversations with residents, the manager and staff; sharing a meal with residents, reading of care plans and records; comments received prior to the inspection from resident, their relatives/visitors, GPs and other healthcare and social care professionals; and a tour of the home. What the service does well: What has improved since the last inspection? Details of how to make a complaint and the procedure followed are now included in the statement of purpose and service user guide so that prospective residents know what to expect. The complaints procedure has been updated to include details of how to contact the Commission. Care plans are being developed further and set out in detail the action staff must to take to meet residents’ health, personal and social care needs. Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 6 Details of when healthcare professionals are asked to visit and the outcomes are now recorded separately and more detailed risk assessments, covering manual handling and areas of the home or grounds that present a risk of falling to individual residents are now being carried out. Residents have a choice of meals. Improvements have been made to menus which have been approved by a nutritionist and ensure a balanced and nutritious diet is available. Bathroom doors have been fitted with signs so that residents are aware they are bathrooms. The manager has begun the Registered Managers’ Award and aims to complete this within two years of the date he was employed. 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. Gardenia House DS0000023943.V299322.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 Gardenia House DS0000023943.V299322.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4 & 5 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information needed to choose a home which will meet their needs EVIDENCE: There is a statement of purpose/service user guide available for all residents and prospective residents, this includes details of how to make a complaint and the procedure that will be followed so that prospective residents know what to expect. Prospective residents and their relatives are encouraged to visit the home before making a decision. There is also a month trial period on both sides, during which time a full assessment of the needs of prospective residents is carried out and recorded. Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The health and personal care, which a resident receives, is based on their individual needs and promotes their safety however, some information is out of date. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Care plans seen contained information about residents’ personal and health care needs and included records of the personal care residents have received. Care plans are being developed further and set out in detail the action staff must take to meet residents’ health, personal and social care needs, however regular reviews are not being carried out to ensure that these are up to date, not all documentation is signed and dated. Details of when doctors and details of when other healthcare professionals are asked to visit and the outcomes of these visits to residents were seen in care plans which show that residents have access to these services when needed. Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 10 Basic risk assessments that ensure the general safety of residents have been carried out and these are being expanded to include more detailed assessments, covering manual handling and areas of the home or grounds that present a risk of falling to individual residents to safeguard residents from harm be carried out. Senior staff have attended risk assessment training to improve their skills and knowledge as they carry out more detailed assessments. Residents said that all their needs are being met and they are very happy with the help and support they get. They said “staff are very good” and they feel “very happy and comfortable”. Staff clearly got on well with residents and treated them with respect. The safety of residents is promoted through safe systems for handling and storing medication. Medication is stored appropriately and medication administration records are accurately recorded. Risk assessments that had been carried out for residents who self medicate are also kept with these records. Controlled drugs records match medication stored in the controlled drugs cupboard. Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 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 - 15 Quality in this outcome area is excellent. This judgment has been made using available evidence including a visit to this service. Residents are able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet resident’s expectations. Residents receive a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: A range of activities is available for residents to take part in including 40’s and 50’s karaoke, music, books, videos, bingo word games and outings. Details of the activities planned are displayed around the home. The activities coordinator is working to develop these even further, consultation takes place with residents to plan activities and outings. Residents said they had enjoyed a recent outing to Southend and others were going on another outing this week. Opportunity is also available for residents to take part in church services if they choose to. Routines in the home are flexible and relevant, residents enjoy the freedom to come and go as they please. Breakfast can be taken at any time between 7.30 and 10.30 a.m. They are able to use all communal areas, some were seen sitting in the lounge and dining room. Residents said that they can join in the Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 12 activities whenever they want and enjoy the buffet teas once a fortnight. They also talked of other activities provided, such as bingo and going to shows. Visitors are welcome in the home and are able to spend time with the residents in private. Residents have a choice of meals, improvements have been made to menus and expert advice has been sought from a nutritionist who commended the food and provided information for residents and staff about healthy eating. The lunch on the day of the inspection was very good with choice offered of drinks, main course and dessert. Special diets are catered for. Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 13 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): 16 and 18 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Residents have access to an effective complaints procedure and are protected from abuse EVIDENCE: There is a clear complaints procedure which is displayed in the home which includes details of how a complainant can contact the Commission. The home’s service user guide includes full details of the complaints procedure and informs residents about the process and what to expect. Residents said that they were listened to and felt free to offer comment or complaint. Residents are protected from abuse through clear procedures, sound recruitment practice and staff training. Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. There may be some risk to people who live in the home where boundaries are not secure. EVIDENCE: The home is situated on the outskirts of Dartford. It has an entrance lobby leading into the main entrance hall with a lift to bedrooms on the first and second floors. Residents can use grab rails and other aids that have been provided around the home. All bedrooms are single with en suite facilities and some also have a shower. There are bathrooms with bath hoists on each floor which are clearly marked so that residents are aware they are bathrooms. Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 15 There is a comfortably furnished lounge on the first floor that also contains a dining table and chairs. The manager is hoping to create a small kitchenette area with a microwave and kettle in the corner of this room. The dining room is on the ground floor with two fire doors leading to gardens to the back and side of the home. The kitchen leads from this room. A sign is displayed on the wall next to the fire exit to the rear garden giving times that residents can smoke in this area. Discussion took place about the appropriateness of having a designated smoking area in the dining room when residents have to eat in there, alternative arrangements for smoking are being explored. There are limited car parking spaces to the front of the house. The garden area to the side is surrounded by fencing and clearly belongs to the home. However, at the rear of the property the boundary for the home is not clear. There is a small patio area directly outside the fire door leading from the dining room. However, a path leads to a grassed area behind the patio that is to the rear of private houses opposite. A path to the left of the building leads to a side door access to the Baptist church. The manager advised that Heritage Care is currently looking at confirming and identifying the boundaries of the home. Residents’ rooms were comfortably furnished and contained the residents’ own furniture and effects and residents said they were comfortable in the home. Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 16 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 - 30 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of residents. EVIDENCE: There were two carers and the deputy manager on duty to look after 21 residents. Staff were able to carry out their duties unhurriedly and efficiently and had time to speak with residents. A cook, the administrator and the manager were also on duty. A staff list and duty rosters seen showed that an appropriate number of staff are on duty and residents’ needs are met at all times. Recruitment practice protects residents, vacancies are advertised centrally, there is one vacancy at the moment which is being covered through agency staff. Staff files seen contained all the information required including CRB checks and two references. The care and welfare of residents is promoted through good training and staff development opportunities, thirty per cent of staff have achieved at least NVQ 2 in care with two more due to complete soon. A further three members of staff have recently started the course. In addition three members of staff are due to start NVQ 3 in care. The induction and core training provided is assessed and reviewed by the senior carers and updates and further training Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 17 are provided when needed. Induction records seen had not been signed off to confirm that staff had completed the induction programme or that their competency and understanding had been fully assessed. The manager will remind senior staff to ensure that records of induction are fully completed with signatures of the trainer and inductee and dates. Training records and certificates seen in staff files showed that staff have received training in manual handling, first aid, fire safety, food hygiene and medication over the last year. Training also includes adult protection, risk assessment, nutrition, infection control and customer care. Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 18 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): 31,32,32,35,36 & 38 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Residents benefit from living in a home which is well managed, safeguards their best interests and promotes and protects their health, safety and welfare. EVIDENCE: The manager has a number of years experience and has begun the Registered Manager’s Award . Residents and stff said the manager was very approachable. There is a calm and pleasant atmosphere in the home and residents spoken with were happy and contented. A number of comment cards were received prior to the inspection from residents and their relatives or visitors who visit the home which were all complimentary. Residents stated that they like living there, feel well cared for, are treated well and feel safe. Relatives or visitors said they are always made welcome, can visit in private, are kept informed of Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 19 important matters, are consulted and all are satisfied with the overall care provided. Additional comments included “first class”, “very well cared for”, and “staff go out of their way to make sure … is ok”. Small amounts of cash are kept for some residents in a locked safe in the home. Individual records are kept and those sampled at the last inspection tallied with receipts. Details were also seen at that time of monthly audits of these records that had been carried out by the manager. Senior carers monitor and carry out formal recorded supervision of care staff. Records seen showed that care practice, training and development needs are discussed with staff. Supervision is usually carried out two monthly. Training records showed that staff receive regular updates on manual handling to avoid injury to residents or themselves and regular fire training is provided. The home uses the company’s own accident book. Separate copies of accident reports are removed from the book and stored securely and confidentially for each resident. Pre-inspection information received and records sampled showed that all maintenance contracts and checks had been carried out and residents live in a safe and well maintained home. Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 20 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 3 x 3 Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 21 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 OP7 Regulation 15 Requirement The registered person shall keep the service users plan under review. The premises must suitable for the purpose of achieving the aims and objectives set out in the statement of purpose. The issues agreed with the manager as necessary are: the identification of the homes perimeters and subsequent maintenance of these. This requirement is continued from the previous inspection on 9 September 2005 and 14 February 2006 Timescale for action 31/07/06 2 OP19 23 31/07/06 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 Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 22 1 OP30 Records of induction should be fully completed with signatures of the trainer and inductee and dates. Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Gardenia House DS0000023943.V299322.R01.S.doc Version 5.2 Page 24 - 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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