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Inspection on 08/02/06 for Garrett House Residential Home

Also see our care home review for Garrett House Residential Home for more information

This inspection was carried out on 8th February 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.

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

What the care home does well

Garrett House continues to provide high quality of care to residents whose needs fall within the home`s categories of registration. The home has continued its cycle of development by introducing new assessment forms and care plan documentation. At this inspection, evidence was seen of good practice in relation to nutritional monitoring and continence care. The overall package of care has been the subject of complimentary correspondence from the relatives of residents.

What has improved since the last inspection?

As stated above, developments include new pre admission assessment forms, and care-planning documentation, which has addressed the minor issues raised following the last inspection of the home.

What the care home could do better:

No areas for development were identified at this inspection, which only covered a small number of National Minimum Standards in total.

CARE HOMES FOR OLDER PEOPLE Garrett House Residential Home 43 Park Road Aldeburgh Suffolk IP15 5EN Lead Inspector Joe Staines Unannounced Inspection 8th February 2006 03:00 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 Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 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. Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Garrett House Residential Home Address 43 Park Road Aldeburgh Suffolk IP15 5EN 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) 01728 453249 01728 453249 Mrs W Stedman Mr B Stedman Mrs W Stedman Care Home 45 Category(ies) of Dementia (6), Old age, not falling within any registration, with number other category (39) of places Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th August 2005 Brief Description of the Service: Garrett House is a large Georgian house, which has been in use as a care home for older people since 1982. The Home is located on a private road within a residential setting in the costal town of Aldeburgh. It is situated in grounds of approximately four acres of landscaped gardens, which incorporate a croquet lawn, tropical themed courtyard, a summerhouse and a fenced pond. The House has views to the river Ald. The main house and extension offer accommodation on two floors. There is a passenger lift serving both sides of the Home. Most of the bedrooms are single however two large bedrooms are available should couples wish to share. All the bedrooms in the extension have en suite facilities, as do many in the main house. As a result of recent developments, the home now has four new rooms, and has increased its capacity from 41 to 45 service users. Further developments to create additional space are currently being considered by the owners. Garrett House is registered under the Care standards Act 2000 as a Care Home to accommodate up to 45 older persons, including 6 individuals with dementia. Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the second inspection of Garrett House to take place during the inspection year ending 31st March 2006. The inspection covered those key standards not assessed at the home’s unannounced inspection of 25th August 2006. Both reports together provide an overall assessment of the home’s compliance with all of the National Minimum Standards identified by the commission as needing to be inspected during a 12-month period. The inspection included informal discussions with 3 residents, detailed discussions with the management team, and an interview with a visiting health care professional. As part of the inspection, the inspector passed a complaint on to the proprietors. Subsequent to the inspection, and prior to the production of this report, the proprietors completed a thorough investigation and found the complaint to be not upheld. The Commission for Social Care Inspection has received a report of the investigation and findings and has accepted the findings of this investigation. What the service does well: What has improved since the last inspection? What they could do better: No areas for development were identified at this inspection, which only covered a small number of National Minimum Standards in total. Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 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. Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 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 Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 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): 3 Residents and their representatives, can be confident that the home undertakes thorough pre admission assessments with relation to people considering moving into the home. EVIDENCE: The manager reported that no new admissions had taken place since the last inspection of the home. However, new assessment forms had been produced, which provide a clear basis for thorough assessments covering all of the areas identified in the National Minimum Standards, and additional information to give as complete a picture as possible of the prospective resident’s needs. Additional assessment forms are used for manual handling, continence, environmental risks and medication, which enhance the main assessment form. Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 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 Residents, and their representatives, can be confident that the home provides individual plans of care, which set out the needs of residents in relation to their health, personal and social care needs. Similarly, residents and their representatives can be confident that the home ensures that the health care needs of residents are met, including those relating to the medication needs of residents. EVIDENCE: The care plans examined by the inspector as part of this inspection showed evidence of resident’s involvement in the form of signatures on the front of the care plan. The plans also had review sheets for care staff to record two weekly reviews, a statement of the purpose of care plans, space to record appointments, monitoring and assessment of personal hygiene records, guidelines, bathing procedures, medication, weight, other agencies involvement, progressive care dependencies, intervention strategies, behaviour charts, daytime occupations, leisure and hobbies and weekly timetables. Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 Page 10 A number of the sections of the care planning document above provided evidence of health care needs being met through routine appointments and health monitoring. The Community nurses and GP appointments were seen to be diarised, and their involvement recorded in service users individual care plans. Plans included specific arrangements for the provision of personal care. The examination of resident’s records confirmed that fluid intake was monitored and food charts were in place where a need was identified, and pressure monitoring was taking place. The medication administration records were examined, and found to be well maintained. The records included indication of the dosage, where this was variable and clear records in the event of the non-administration of medication, including the reason for the non-administration. Medication reviews were being undertaken in respect of all residents and the inspector was able to interview the visiting pharmacist, who was working with the home on this task. The pharmacist confirmed that the home manages the medication needs of residents well and stated that their overall observations of care provided were extremely positive. The manager described how the medication reviews had resulted in the identification of one resident with (previously undiagnosed) diabetes. Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 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): None of the above standards were assessed on this occasion. All of the standards above were assessed as fully met at the inspection undertaken in August 2005. EVIDENCE: Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 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): None of the above standards were assessed on this occasion. All of the key standards above were assessed as fully met at the inspection undertaken in August 2005. EVIDENCE: Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 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): None of the above standards were assessed on this occasion. All of the key standards above were assessed as either fully met or exceeded at the inspection undertaken in August 2005. EVIDENCE: Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): Residents, and their representatives, can be confident that the home provides staff in sufficient numbers to meet the needs of residents. EVIDENCE: On the day of the inspection there were 5 carers on duty in the morning and 3 in the afternoon/evening. Two waking night staff were employed. Examination of the rotas confirmed that these levels are being maintained. Given the number of service users accommodated, and their dependency levels, these staffing levels are agreed as adequate. Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 35 Residents, and their representatives, can be confident that the home protects the financial interests of residents. EVIDENCE: The home does not take any responsibility for service users financial affairs. The extent of involvement with service users money is limited to safekeeping of petty cash and other items of modest value, which is properly accounted for and safely stored. The inspector viewed the cash records for 3 residents. All of the amounts tallied and records were being maintained. Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 Page 16 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 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 Page 17 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. Standard Regulation Requirement Timescale for action 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 Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Garrett House Residential Home DS0000024394.V283382.R01.S.doc Version 5.1 Page 19 - 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!