Inspection on 29/01/08 for Garswood

This inspection was carried out on 29th January 2008.

CSCI found this care home to be providing an Excellent service.

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

Garswood 31/10/06

Garswood 13/02/06

Garswood 20/10/05

Garswood 22/02/05

Garswood 31/08/04

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

CARE HOMES FOR OLDER PEOPLE Garswood 32 Trafalgar Road Southport Merseyside PR8 2HE Lead Inspector Mrs Margaret Van Schaick Key Unannounced Inspection 29th January 2008 09:00 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 Garswood DS0000005345.V353248.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. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Garswood Address 32 Trafalgar Road Southport Merseyside PR8 2HE 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) 01704 568105 Christadelphian Nursing & Residential Care Miss Phillipa Bates Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 42 service users to include:* up to 42 service users in the category of OP (Old age, not falling within any other category). October 2006 Date of last inspection Brief Description of the Service: Garswood is an older detached property dating back to 1892 that had been converted into a care service in 1948 and provides residential care for fortytwo Older Persons. There is a large extension to the rear of the property and substantial garden grounds surround the property on three sides with ample parking for visitors and staff. It is situated in a residential area of Southport close to public transport and within easy reach of the amenities that serve the Southport and Birkdale area. The service provides accommodation over four floors, with lift access to each floor. There is ramp access to various parts of the service also. Garswood has 26 single bedrooms and 8 double bedrooms all have en-suite facilities. The communal space provides one dining room, two lounges and a conservatory. There are also small seating areas situated throughout the service which some of the residents where observed to use. The large games/function room is at present unused. The service has an external lift in place, which enables service users to access the rear gardens. The service has a summerhouse, which is pleasantly situated in the rear garden. The home has suitably adapted equipment to assist with the varying needs of the service users. There is a call-bell system throughout the service. A ‘loop system’ is in place in the meeting room for the hearing impaired resident. Garswood is owned by a Charity Organisation, Christadelphian Care Homes and is managed by Miss Pippa Bates. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. A site visit took place as part of the unannounced key inspection. It was conducted over a two-day period for the duration of 10 hours. 32 residents were accommodated at this time. As part of the inspection process all areas of the service were viewed including some of the residents bedrooms. Care records and other home records were viewed. Discussion took place with some of the residents, staff and visitors. The inspection was conducted with Pippa Bates, registered manager. During the inspection 3 residents were case tracked (their files were examined and their views of the service were obtained). All of the key standards were inspected and also previous requirements and recommendations from the last inspection in October 2006 were discussed. Satisfaction forms “Have your say about…” were distributed to a number of residents, relatives and health care professionals prior to the site visit. A number of comments included in this report are taken from the surveys and from interviews. An AQAA (annual quality assurance assessment) was completed by the manager prior to the visit. The AQAA comprises of two self-assessment questionnaires that focus on the outcomes for people. The self-assessment provides information as to how the manager and staff are meeting the needs of the current residents and a data set that gives basic facts and figures about the service including staff numbers and training. Weekly fees are £400-£520. What the service does well: The service continues to provide an effective pre admission assessment for all prospective residents and this ensures that resident needs are met. Residents interviewed confirmed their needs were being met. One resident stated, “I like Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 6 it tremendously, I decided the first time I came that I would retire here rather than anywhere else. I have had no reason to regret the choice I made”. The service provides residents with individually identified care and support to meet their needs. This was confirmed through resident interviews and all were satisfied with medical input and care plans to support them. One relative commented, “my aunt had everything explained to her very well. She was involved in preparing her care plan when she moved in”. Excellent support from staff, relatives, friends and ‘friends of Garswood’ ensure that residents are able to live their lives as they please. Residents interviewed stated, “I’ve been very fortunate living here, I can please myself”, “you get good care, you’d be lucky to come here”. One relative commented, “Garswood provides a friendly environment with regular visits from other Christadelphians who spend time with the residents and arrange outings for them”. Policies and procedures in place ensure that all residents and staff are protected from abuse. Good records are kept of all financial transactions including receipts and the manager and secretarial staff audits these regularly throughout the year Garswood provides the residents with a comfortable and well-maintained service that is continually improving facilities for the residents who live there. It is furnished and decorated to a very high standard. Bedrooms are generally specious and hallways are wide with handrails in place to ensure easier passage for residents. One resident interviewed stated, “I’m very happy with my bedroom, it’s home. They brought my furniture here with me. I’m very happy with that”. Staff interviewed confirmed that they had a good training programme. Residents interviewed confirmed that staff were able to meet their needs and were complimentary about them. Residents and relatives comments include: Garswood has excellent management systems in place, which ensures the health and safety of residents and staff. Residents are very much included and involved in the service. They are regularly canvassed for their views of how the service is run. What has improved since the last inspection? All staff now signs the medication records following administration of medication. Antibiotics are now administered at prescribed times as recommended. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 7 All medication received into the service is booked in correctly outside of normal monthly ordering procedures. Where one or two tablets are prescribed there is clear entries on the medication records stating which amount is administered each medication round. A rolling plan of refurbishment is in place to provide residents with facilities that suit their individual needs. Each bedroom has an en-suite facility and these are being upgraded to provide further adaptations for residents. Bedrooms are being upgraded also when they become vacant and include new fitted furniture. Additional communal bathing facilities are available on each floor with adaptations fitted. The garden grounds have been re furbished and the pool is now ‘filled in’. Further planting of bulbs, trees and shrubs and new fencing is in place. The garden continues to be easily accessible for residents. Miss Pippa Bates was approved as the Registered Manager in February 2007. Since her appointment Miss Bates has improved the management of the service and residents and staff confirmed that they had confidence in her ability to manage the service well. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 8 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. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 9 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 Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 10 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): OP3 was assessed. OP6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service continues to provide an effective pre admission assessment for all prospective residents and this ensures that resident needs are met. EVIDENCE: Three of the residents care files were case tracked and pre admission assessment documentation was examined. All three residents evidenced pre admission assessments were carried out. Records show previous medical history and a list of current medications are on file. The assessments are detailed and comprehensive including healthcare needs, preferences, social and religious needs. The documentation includes detailed information, which identifies personal details and family contacts. Information gathered prior to admission covers many areas including history of falls, immediate health care needs, preferred foods and allergies. The assessment documentation also confirms family and friend contacts and their input. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 11 The manager visits prospective residents in their home or at the hospital prior to admission. Some prospective residents have visited Garswood for meals, respite or holidays therefore enabling them to see what the service would have to offer before deciding to become a permanent resident. During these visits staff can further assess prospective residents needs. A resident interviewed stated, “I came for respite before and a holiday in August 2006. I was fully aware of what Garswood had to offer. I like it tremendously, I decided the first time I came that I would retire here rather than anywhere else. I have had no reason to regret the choice I made”. Residents confirmed through discussion that their needs were being met. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 12 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): OP7,8,9,10 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service provides residents with individually identified care and support to meet their needs EVIDENCE: Three of the residents care files were examined as part of the case tracking process. Care files viewed were organised and generally easy to follow. All three residents case tracked had a plan of care covering support and care needs. Care plans viewed included a detailed plan of care to meet the individual residents needs. Care plans are set up on a typed format with a comprehensive list of areas to be looked at following the assessment. The care plans are individualised to specific residents needs. Daily evaluations of care are recorded and the care plan progress is updated every 2 days. Each area of need is signed by the residents or relative where needed. The manager stated that all care plans are reviewed 3 monthly but there is no record of this therefore the manager was advised to do this. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 13 There is evidence that care plans have been updated when needed following changes in care needs. Residents interviewed confirmed they were happy with the care and support received. Some residents stated: “I’m thoroughly happy here, there are no faults at all” “I take my own medicine, the home orders it, it’s never late” “whenever I’ve wanted to see my GP I see him, they have a good link with him” “Once a month we discuss and agree my care plan” Other comments received from residents and relatives include: “my aunt had everything explained to her very well. She was involved in preparing her care plan when she moved in” “it’s first class” “Garswood provides a loving and caring environment” “staff regularly take …..to Doctor or hospital appointments if I’ am not available” “they arrange for a physiotherapist to come to the home to encourage mobility” Health professionals canvassed for their views gave positive responses. Staff handovers take place at the change of staff shifts therefore ensuring staff are brought up to date with residents varying needs. Waterlow scores are monitored (tool to measure risk of developing pressure sores). Other health personnel intervention including GP, dietician, chiropodist, optician, dentist and hospital visits are recorded. Weights are recorded regularly. Where needed pressure relieving equipment is in place. Manual handling assessments are in place. Risk assessments are in place for residents for various activities and include such areas as mobility, falls and self-medication. Medication records are much improved. One resident interviewed stated, “Medicines are given on time” The treatment room/staff station is well organised. Medication was stored securely. A medication fridge is in place with daily record of temperatures at satisfactory levels. Resident medication records were neat and organised. Photographs of residents are in place, which helps to identify residents. Accurate records are kept of prescribed medication, dose and amount to be given to residents. Amounts of medication delivered to the service are recorded with signatures and dates recorded. An explanation of each prescribed medication is in place on the individual residents file. Stock in place was in date. Residents who self medicate have their stock checked 2 monthly. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 14 A returns book is in place and medication returned is listed and signed and dated by pharmacy collector. Medication prescribed as one or two has clear records of what amount has been given each day. Antibiotics are given at the prescribed times now. All medication administered is now signed for there were no missing signatures/initials. Through discussion with staff responsible for administering medication it is apparent that good practices are in place. Residents receive healthcare and other professional visitors in the privacy of their rooms. This was observed during the inspection visit. Residents interviewed stated, “I see my GP and chiropodist and there is no difficulty to see the optician and “Staff always knocked on bedroom doors prior to gaining permission to enter. Some of the residents have their own telephone line and a public phone and office phone is made available for residents use. Residents were treated courteously and respectfully during the visit. Residents are addressed how they wish as observed during the visit and in care documentation. One resident interviewed stated, “I can have cups of tea and anything I want-I have no difficulty getting what I want. They just anticipate my wants and they (staff) are ever so good”. During the visit all of the residents looked well groomed and cared for. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 15 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): OP12,13,14,15 were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Excellent support from staff, relatives, friends and ‘friends of Garswood’ ensure that residents are able to live their lives as they please. EVIDENCE: Most of the residents at Garswood choose to live their lives by practising their faith and live amongst their ‘brothers and sisters’. They are then able to continue to practice their religion freely. One resident interviewed stated, “the main reason I came here is I can have Bible readings every day and with other people”. For over a year now, the service enables a small amount of people from other religions to live at Garswood. This does not seem to have had any adverse effect on the residents who have lived in Garswood for many years. Residents have support and friendship of ‘friends of Garswood’ who are able to assist in taking residents out or to just spend time with them. Residents go to the Christadelphian Church for regular services and daily readings are held in the large sitting room. The sitting room is fitted with a ‘Loop’ system to aid the hearing impaired. Residents who do not practice their religion do not need to attend the meetings if they do not wish to. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 16 One relative commented, “ ….is not a Christadelphian and the staff helped ….to attend her own church on Sunday mornings, they provide a taxi to take and collect her”. The service also has a car to transport residents where they wish. Various activities are arranged for residents and they can choose to attend or not. The activities include daily readings, art works, mid week shop, afternoon activities with staff such as games, sing-a-longs and videos. Some residents also make crafts, greetings cards and attend a wood carving class. The home also offers trips out to areas of interest. One resident interviewed stated, “we have very good activities particularly on Wednesday, games, quizzes-out in the garden, outings, I join in all of them”. Some of the residents have an interest in gardening and are actively involved within their abilities. Residents are given support by staff to get up and go to bed when they wish to. Residents in general within their abilities live their lives as they please. Families and friends are encouraged to visit the service when they wish. Residents interviewed confirmed they were happy living in Garswood. Some residents stated: “I’ve been very fortunate living here, I can please myself” “you get good care, you’d be lucky to come here” “we had four or five owls here about a couple of weeks ago, European Eagle Owls, I’d have a job to find somewhere better” “they just anticipate my wants and they are ever so good” Relatives and residents comments include: “Because of the varying and different needs of the residents, I think the staff all do a remarkable job of treating them as individuals and helping them to keep their identity” “staff regularly ask …..what she would like to do, very often she chooses to be in her own room and that is respected”. “they have encouraged ….to be as independent as possible in a safe environment” “I feel very well blessed to be able to live here” “Garswood provides a friendly environment with regular visits from other Christadelphians who spend time with the residents and arrange outings for them”. The menu is varied and provides a nourishing diet. The cook speaks with the residents regularly and knows all of their likes and dislikes. Residents were complimentary about the meals provided. Alternatives to the menu are always available. The meals provided today where printed in large letters on the wipe clean board in the dining room. There is only one main course choice printed but on discussion with the cook she stated,” I know what the residents like. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 17 Those who don’t like the main course always have another –whatever they wish”. Residents interviewed confirmed this. The menu is varied and suitable for their needs. Fresh fruit was on display for residents use in the dining room and residents interviewed confirmed this was normal. There were many choices for tea and a cooked breakfast is available for residents who prefer it. Snacks and drinks are available for residents throughout the day/night when they wish. The dining room is pleasantly decorated with various tables dressed with table linen/napkins and matching cutlery and crockery. Staff were available to offer discrete support to residents. This was observed during the inspection. Residents interviewed stated, “food is excellent, beautifully cooked it’s a good all round menu, it’s always warm, vegetables are fresh and we have more than enough food”. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 18 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): OP16,18 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies and procedures in place ensure that all residents and staff are protected from abuse. EVIDENCE: The Sefton adult abuse procedure is in place. It is clear and easy to follow. The complaints procedure is available for residents and some of the residents canvassed for their views were aware of it. None have used it or wished to complain. An anonymous complaint was raised with the commission last year. Following investigation the complaint was unfounded. No further complaints have been raised. The home has clear policies and procedures in place with regard to abuse. Through discussion with staff it is apparent that they are aware of and have a good understanding of the various forms of abuse. Policies and procedures are in place but some senior staff that may be left in charge may need further training to ensure they are confident with the new Sefton Procedures. Staff has attended training with regard to older person abuse as evidenced in staff files. Residents have the contact details of local advocacy services. Residents interviewed were aware of how to complain and relatives commented, “I think it is unlikely that I would need to complain, the manager is always quite happy to address any concerns” and “thankfully, I have never needed to complain”. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 19 All residents have their own bank accounts and mange their money with relatives input where needed. Good records are kept of all financial transactions including receipts and the manager and secretarial staff audits these regularly throughout the year. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 20 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): OP19,26 were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Garswood provides the residents with a comfortable and wellmaintained service that is continually improving facilities for the residents who live there. EVIDENCE: Garswood is well maintained inside and outside including the garden grounds. A tour of the service including some of the resident bedrooms took place. Garswood is furnished and decorated to a very high standard. A rolling plan of refurbishment is in place to provide residents with facilities that suit their individual needs. Each bedroom has an en-suite facility and these are being upgraded to provide further adaptations for residents. Bedrooms are being upgraded also when they become vacant and include new fitted furniture. Additional communal bathing facilities are available on each floor with adaptations fitted. Bedrooms are generally specious and hallways are wide with handrails in place to ensure easier passage for residents. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 21 One resident interviewed stated, “I’m very happy with my bedroom, it’s home. They brought my furniture here with me. I’m very happy with that”. Cinema equipment for residents use is fitted to the lower large sitting room. The gardens have been overhauled over the last 2 years. A new patio and lift from the upper sitting room has been fitted so that residents can access the garden grounds from the upper lounge. The garden grounds are well maintained with many shrubs and bulbs planted for resident enjoyment. The summerhouse is in use in more pleasant weather and all of the grounds are accessible for residents with suitable garden furniture provided. The laundry is on the ground floor of the annexe and is large and airy and accessible for residents who use this facility. The laundry is well organised and freshly clean and tidy. The service throughout is cleaned to a very high standard. Residents confirmed this was usual. Residents interviewed confirmed they were happy with the laundry service. One resident interviewed stated, “I have never had anything go wrong with the laundry, they iron it for me”. A secure facility is in place to store cleaning liquids. Hand washing facilities and protective clothing is available for staff. A separate hairdressing facility is also in place for resident use. Fire exits have been refurbished including new fire safety signs. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 22 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): OP27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service needs to ensure that staffing levels are monitored to ensure resident care is not compromised. EVIDENCE: The staffing rota evidenced satisfactory levels of care and domestic staff is employed in the service. The manager has set up a ‘bank’ of staff to cover staff shortage during periods of sickness. Staff interviewed confirmed there were occasions when they were short of staff and stated, “sometimes on holidays we have 4 in the mornings and there had been occasions when we have been short on nights therefore a ‘senior’ has to sleep over”. One staff interviewed confirmed that resident care was not compromised. Further comments with regard to staffing shortage were made in staff questionnaires, including “on occasions there are problems in covering shifts as there is a shortage of staff” and “at times it is difficult to provide ‘service users’ individual needs due to staff short falls”. A resident interviewed stated, “I don’t think there is enough staff on duty”. Therefore staffing levels need to be monitored. The manager is supported in her position with an administrative assistant. Many of the care staff has qualified to Level 2 NVQ. Further training including mandatory training is provided for all staff. The service also provides additional training to ensure resident needs are met. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 23 Staff interviewed confirmed they had an induction on commencement of employment although one staff file did not evidence this. Some of the staff interviewed confirmed they had their induction booklet at home. Residents are always escorted to hospital and staff or welfare visitors ensure residents in hospital have regular visitors. Residents interviewed confirmed they were happy with staff employed in the service and statements include: “staff “staff “staff “they are are are are absolutely excellent” ever so good” pleasant and patient with other residents” grand, that’s my view of them” Relatives comments received include: “staff seem to be efficient in the various jobs they are employed in and they are always kind and caring” “I always find the staff to be helpful, understanding and sympathetic” “staff have provided support and friendship during a difficult time” Staff interviewed were happy with the training provided and comments received through questionnaires include: “If I don’t have the knowledge, there is always somebody I can ask” “there are a wide variety of courses, which staff can attend”. “I am enjoying work here, its very nice staff are lovely, residents are well cared for” “If I had a relative who needed care, I would be happy to put them here”. Staff files viewed evidenced all mandatory training such as fire, manual handling, food hygiene, health and safety, infection control, Pova (Protection of Vulnerable Adults) and 1st aid. Additional training includes diabetes, medication, disability awareness, equality and diversity and epilepsy. Staff meetings are carried out throughout the year where staff discusses 2 policies at length and any further new policies/procedures are discussed also. The training matrix evidences all previous training dates and also a plan of training for 2008 to include all staff. Although the service provides training with regard to adult abuse staff that may be left in charge need to be clear about the local procedures. Pre employment procedures are in place and staff files evidence that all pre employment checks have been carried out. One care staff has only the standard CRB (Criminal Records Bureau) check in place. The manager was advised. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 24 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): OP31, 33,35,38Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Garswood has excellent management systems in place, which ensures the health and safety of residents and staff. EVIDENCE: The registered manager has the NVQ Level 4 qualification and the RMA (Registered Managers Award) and was approved as the registered manager in February 2007. The manager continues to update her qualifications and attends mandatory training. Residents and staff were very complimentary about the manager and how the service is run. One resident interviewed stated, “Pippa is lovely, very understanding”. Staff interviewed stated, “she is a good manager, I could talk to Pippa” and “I find the manager approachable-if worried I would be able to talk to her”. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 25 Residents are very much included and involved in the service. They are regularly canvassed for their views of how the service is run. This can be through ‘Friends of Garswood’ welfare visits and questionnaires distributed each year. The results of questionnaires were positive. Quality assurance audits are carried out annually and the welfare committee assist residents and families with the questionnaires where needed. Monthly reports are carried out with records kept at Garswood. The reports evidence residents; staff and families are spoken with. All grounds and the building, externally and internally including equipment and furnishings are looked at. Resident social activities and accident records are viewed also. The manager is able to meet with the residents in private when they wish. She has an open door policy and residents were observed during the inspection to knock on the door to speak with the manager during the visit. Residents meetings are held throughout the year. Minutes are published and were viewed during the visit. The welfare committee also meet regularly throughout the year to discuss resident activities, new legislation, any new policies and procedures that may affect the work that they do with residents. Staff meetings are held on a regular basis throughout the year. The manager carries out regular audits with records kept. These include medication, resident finances, care plans, care logs and risk assessments, which were viewed during the inspection. Local pharmacy audits are also on record. Monthly checks of the building are carried out to include 3-6 monthly audits. The senior management team carry out health and safety audits annually with a report published each year covering all areas including, gardens, building structure, environmental health compliance and maintenance of services. Policies and procedures are reviewed annually or sooner. Resident finances have been addressed earlier in this report. All records to do with the health and safety of residents, staff and environment are in place and up to date. All servicing and checks with regard to equipment are up to date. A fire risk assessment of the building is carried out 6 monthly and all fire checks and staff training is carried out on a regular basis. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 26 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 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 4 Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP29 Regulation 19 (1) (b) (i) Requirement The registered person must ensure that the carer identified during the inspection has their CRB checked at the Enhanced Level. Timescale for action 02/04/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP18 OP27 OP30 Good Practice Recommendations It is recommended that the service should ensure all senior staff is confident with the new Sefton Adult Protection Procedure. It is recommended that staffing levels should be monitored to ensure resident care is not compromised. It is recommended that all staff induction records should be documented in staff files. Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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 Garswood DS0000005345.V353248.R01.S.doc Version 5.2 Page 29 - 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!