Inspection on 18/06/07 for Gardner House

This inspection was carried out on 18th June 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

Gardner House 29/06/06

Gardner House 17/01/06

Gardner House 08/11/04

Gardner House 12/07/04

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

CARE HOMES FOR OLDER PEOPLE Gardner House Brierton Lane Hartlepool TS25 4AG Lead Inspector Bridgit Stockton Unannounced Inspection 12 June 2007 10:30 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 Gardner House DS0000021739.V339846.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. Gardner House DS0000021739.V339846.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gardner House Address Brierton Lane Hartlepool TS25 4AG 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) 01429 261023 01429 865950 gardenhouse@c-I-c.co.uk www.c-i-c.co.uk. Community Integrated Care Miss Lisa Newbury Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Gardner House DS0000021739.V339846.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th June 2006 Brief Description of the Service: Gardner House is a care home for older people and is registered to provide care and accommodation for up to 29 older people. The home is well served by bus routes to the town centre of Hartlepool. The home also has a number of lounge areas, dining room, and a quieter room. Menus cater for the specific needs of individual residents. Residents are able to personalise their own rooms and relatives and friends are welcome to visit at any reasonable times. The home has 29 individual bedrooms but does not offer en-suite facilities although they do all have wash hand basins. There are an adequate number of bathing and toilet facilities within the home to meet the needs of the residents. The home has a pleasant enclosed garden to the rear with a number of raised flowerbeds, there are also substantial lawned areas to the side and rear of the building. The weekly fee charged for living at the home is £359.00. Hair dressing, chiropody, newspapers and toiletries are not included in this fee. Gardner House DS0000021739.V339846.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over a period of 5 hours on the 18th June 2007. The home did not know the inspection was going to take place. The plan for the inspection was to check whether the home had implemented the requirements made at the previous inspection; to talk with the people about living in the home; to meet with care staff and the home’s management team; and to look at records. A pre inspection questionnaire had also been returned to the Commission along with some people surveys about living at the home. Some of this information has been included within this report. What the service does well: What has improved since the last inspection? What they could do better: The home still has not employed an activities coordinator and people said during the inspection that there were not enough things to keep them occupied. Key staff require training and updating in infection control procedures. Management need to make sure there is sufficient linen available so that infection control procedures can be followed. The way in which peoples medication is managed needs to be properly organised so people received their medication properly and safely. Gardner House DS0000021739.V339846.R01.S.doc Version 5.2 Page 6 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. Gardner House DS0000021739.V339846.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 Gardner House DS0000021739.V339846.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): 3&6 Quality in this outcome area is good. People can be assured that their needs are appropriately assessed prior to admission to the home and that they are given sufficient information to make an informed choice before moving into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager confirmed that visits to prospective clients always take place before their admission to the home. This is to carry out an assessment of needs. Three care plans examined contained notes from assessments made on these visits. Also, each care plan contained assessments from the placing authority that were responsible for commissioning people’s care at the home. 75 of the surveys returned stated that they had been given sufficient information about the home before moving into it. The home does not provide intermediate care. Gardner House DS0000021739.V339846.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is poor. Whilst the planning of peoples care is good, some people are at risk due to poor medication administration. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The recording in people’s care plans gave instructions to staff on how to meet people’s diverse needs. They also contained up to date risk assessments on people. The plans need to be kept under constant review by all staff; this should be monitored by the manager. People living at the home confirmed that they agreed with the plan of care and some had signed the plan. This is good practice. During the inspection several district nurses visited the home, and care plans indicated that people had access to other health care professionals such as the community psychiatric nurse, opticians and chiropodists. Staff were seen to be treating people with respect and dignity and this was also reflected within the care plans. People said that the ‘girls are kind’ and ‘I have nice friends here’. Gardner House DS0000021739.V339846.R01.S.doc Version 5.2 Page 10 Errors were found in the tablets held on behalf of people living at the home. Audit of peoples medication was made difficult because staff do not record the amount of tablets received into the home. On examination of the medication administration record, some tablets had been signed for as being given, remained in the blister pack. On further discussion with staff, it appeared that some people’s prescriptions had not been sent to the pharmacy on time. This meant that some medication had not arrived on time and some people had gone without some medication for a day. Staff explained that this was the first and only time this had ever occurred. This is extremely poor practice. In addition the home had failed to tell the Commission about this serious error which may have had a detrimental effect on the health and well being of some service users in there care. Hartlepool Primary Care Trust pharmacist was informed who visited. She is now working with the home’s management team to rectify the problems surrounding medication Gardner House DS0000021739.V339846.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. Whilst people confirmed they had choice in some aspects of daily routines, improvements in the provision of activities would enhance people’s individual social and occupational needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There were some activities taking place such as board games and bingo and external entertainers came to the home from time to time. Some people felt there were not enough activities to keep them occupied. One person said ‘ it would be nice to get out for a bit of fresh air, or go shopping’. Another said ‘the days are long in here, there isn’t much for me to do, the staff are good and they try hard but they are busy’. A dedicated activities co-ordinator would be able to focus attention on this area. The home is currently refurbishing a small lounge and making it into a cinema room to provide some more entertainment for people. People confirmed that they can go to bed and get up when ever they want. One person said ‘the staff help me get into bed on a night time, they know my routine, I get ready for bed early evening, watch some television then they come and put me into bed, that’s what I want’ One resident said that staff were really considerate and looked after everyone’s ‘best interests’ she went on to say that when she was first admitted she had been given a smaller bedroom, staff had noticed that she spent a lot of time in Gardner House DS0000021739.V339846.R01.S.doc Version 5.2 Page 12 the room and very rarely used the communal facilities. She was asked if she would prefer a larger room in which she would be more comfortable. Several people commented on the food during the inspection and said that it was very good. The cook was knowledgeable about what people liked and disliked. Observation of the lunchtime meal provided evidence that people were able to make choices about the meals they wished to eat. One service user said the food was “champion”. Another said ‘ the food is always good, nice and hot and the portions are always decent to’ Gardner House DS0000021739.V339846.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16&18 Quality in this outcome area is good People can be assured complaints would be investigated properly and outcomes recorded. Staff are aware of measures to take in case of abuse of a vulnerable adult. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are adequate written policies and procedures in place to deal with complaints and the care staff spoken to confirmed they were aware of these. People said they would complain to the manager if they were at all unhappy. Written records of complaints and the outcomes are kept at the home. These were inspected and satisfactory. Staff training takes place in the protection of vulnerable adults from abuse. Staff recruitment procedures are adequate and staff were employed and deployed only with CRB and POVA checks. The manager was clear and confident in the protection of vulnerable adults procedures. Gardner House DS0000021739.V339846.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,&26 Quality in this outcome area is adequate The home was clean, comfortable and well-maintained providing people with a pleasant environment. Infection control procedures are not adhered to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual bedrooms and communal areas were suitably furnished and decorated in a style liked by people living there. The home was nice and clean and fresh. One person commented ‘ my room gets cleaned everyday. There are no requirements outstanding from the fire officers visit or from environmental health. The laundry was inspected. It was found that infection control precautions were not always followed. There is one industrial washing machine in use at the home, and one domestic washer for the use of people living at the home who may want to do their own washing. However the staff confirmed that they also use this washing machine, as it is quicker than the industrial one. This machine does not have a sluice cycle and does not heat to the high temperature required for infection control. Therefore is not always suitable for Gardner House DS0000021739.V339846.R01.S.doc Version 5.2 Page 15 the items that are being washed in it. The staff confirmed that some linen is washed externally from the home. The laundress said that some bedding and towels had to be done ‘in house’ because the linen sent away took over a week to return. This, coupled with the increased amount of people who were incontinent meant that there was often a shortage of bedding and towels. The manager must review this situation. Gardner House DS0000021739.V339846.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29&30 Quality in this outcome area is good. The recruitment and training of staff is good which contributes to the ongoing safety of people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From the duty rota examined during the inspection staff are on duty in sufficient numbers to meet the current dependency of people who live at the home. There is a commitment at the home to having a trained workforce with 88 of care staff having completed NVQ level two or three training in care. Staff said they found the training helpful in improving their day-to-day practice. One member of staff said they had received training in moving and handling, fire safety, first aid and infection control. All new staff receive a thorough induction and this was documented in the staff files examined. The home had staff files in place that provided evidence that the appointment of a new staff member is made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. Gardner House DS0000021739.V339846.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good. People can be assured that the care home is managed properly and their best interests safeguarded This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is being managed by an acting manager from another home within the group. Meetings are held to enable people to have a view on how the home is ran. Some people’s personal allowances are held at the home. Financial policy and procedures are in place to ensure that all transactions can be accounted for. Receipts are retained and signatures obtained for any financial transaction regarding people money. The maintenance arrangements and records for the maintenance of the homes equipment were inspected. Regular tests are carried out to ensure that hot water is maintained at safe temperatures and that fire alarms and equipment Gardner House DS0000021739.V339846.R01.S.doc Version 5.2 Page 18 are working correctly. Suitable maintenance contracts are in place for the servicing and maintenance of equipment. Gardner House DS0000021739.V339846.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 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 X 3 X 3 X X 3 Gardner House DS0000021739.V339846.R01.S.doc Version 5.2 Page 20 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 OP9 Regulation 13(4) 17(1) Schedule 3 Requirement To avoid risk to service users health • Medication administered by the home must be given properly in accordance with the prescribers instructions • All medication administered by the home on behalf of the service users must be counted, documented on the medication administration record and signed for on receipt The manager must provide a varied programme of activities that maintains links within local community and takes into account peoples equality and diversity. All soiled laundry must be washed at appropriate temperatures, to minimise infection. All soiled laundry must be transported to the laundry in accordance with the homes policy on infection control DS0000021739.V339846.R01.S.doc Timescale for action 18/06/07 2 OP12 16(n) 01/09/07 3 OP26 13(3) 16(2) 18/06/07 Gardner House Version 5.2 Page 21 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 OP24 Good Practice Recommendations It is recommended that the manager does a stock check on bedding and towels in order that there are sufficient to meet the needs of service users. Gardner House DS0000021739.V339846.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Gardner House DS0000021739.V339846.R01.S.doc Version 5.2 Page 23 - 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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