Inspection on 15/12/05 for Garth House

This inspection was carried out on 15th December 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Garth House 18/12/07

Garth House 01/06/06

Garth House 18/07/05

Garth House 29/11/04

Garth House 05/08/04

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

CARE HOMES FOR OLDER PEOPLE Garth House Tower Hill Road Dorking Surrey RH4 2AY Lead Inspector Mary Williamson Unannounced Inspection 15th December 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Garth House DS0000013322.V273800.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Garth House DS0000013322.V273800.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Garth House Address Tower Hill Road Dorking Surrey RH4 2AY 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) 01306 880511 01306 877640 Assured Healthcare Plc Mrs Janet Maureen Ann Starr Care Home 41 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (41), of places Physical disability over 65 years of age (41), Sensory Impairment over 65 years of age (20), Terminally ill over 65 years of age (20) Garth House DS0000013322.V273800.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. A maximum of 20 Service Users may also fall within the category DE(E) - Dementia, over 60 years of age A maximum of 20 Service Users may also fall within the category TI(E) - Terminally Ill, over 60 years of age A maximum of 20 Service Users may also fall within the category SI(E) - Sensory Impairment, over 60 years of age A maximum of 41 Service Users may fall within the category PD(E) Physical Disability, over 60 years of age Services Users may be admitted from the age of 60 years. Date of last inspection 18th July 2005 Brief Description of the Service: Garth House is a large Edwardian property located on the outskirts of Dorking Town. The home provides care for people, who are old, suffer from dementia, have a terminal illness, or have a physical disability. The home offers accommodation mostly in single rooms, with three double rooms available. All the rooms have en-suite facilities. There are three comfortable lounges, two dining rooms, an air-conditioned garden lounge and a conservatory provided for service users use. There is a large mature, well-maintained garden to the rear of the property, which is well furnished with garden furniture and ornaments. The home changed ownership in November 2005 and is now owned by Caring Homes Limited. Garth House DS0000013322.V273800.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and the second in The Commission for Social Care Inspection programme year 2006/2006. Mary Williamson who is the Lead Inspector for the home undertook the inspection. Louisa Palacios who is The Senior Sister was present throughout the inspection. A tour of the premises was undertaken and records relating to the care of the service users and the management of the home were examined. There was a relaxed atmosphere in the home with the service users enjoying the festive activities, the Christmas decorations, and the musical entertainment provided during the afternoon. The inspector had the opportunity to meet and talk with most of the service users some in more detail than others. It was also possible to talk with visiting relatives. The general feedback regarding the care provided was very positive. Staff were able to confirm some of the training they had received. The inspector would like to thank the service users, and staff for their positive input to the inspection process. What the service does well: The home provides good quality care to service users as identified in well maintained care plans. Staff are professional in their approach and interact in a positive and caring manner with service users. Privacy and dignity are respected and staff were observed to knock on service users doors prior to entering. The accommodation provided is of a high standard. The catering arrangements are good and the home is well managed. Garth House DS0000013322.V273800.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. Garth House DS0000013322.V273800.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Garth House DS0000013322.V273800.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, and 5. These standards remain unchanged since the last inspection. All information is in the process of being updated to include the new company details. EVIDENCE: Garth House DS0000013322.V273800.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10. Service users personal health care needs are met in a respectful manner as outlined in individual care plans. The procedure for the administration of medication is satisfactory. EVIDENCE: Individual care plans are in place. Six of these care plans were sampled during the inspection. The sister on duty explained that these plans are developed following a detailed pre admission needs assessment, and input from the service users whenever possible. The care plans are kept in service users bedrooms, are well maintained and reviewed on a regular basis. Risk assessments covering mobility, prevention of falls, nutrition, and pressure area care are also included in the care plans. All service users are registered with a local GP who visits the home at least once a week or more frequently if required. Visits are also arranged for the chiropodist and optician. Physiotherapy can be arranged privately or on referral by the GP. There are currently no service users in the home with a pressure sore. A wide range of pressure relieving equipment is in place to promote good nursing practice. Garth House DS0000013322.V273800.R01.S.doc Version 5.0 Page 10 There is a policy in place for the administration. The sister in charge stated that this is currently being updated as a new company document. The medication recording charts are well maintained. Boots the chemist supply the medication in blister pack form. There are no service users who currently self medicate but there is a procedure in place for this. Staff who administer medication receive regular training. Controlled drugs were randomly checked and were satisfactory. A policy relating to privacy and dignity was seen. Staff were observed to knock on service users doors prior to entering. Screens are supplied in shared rooms. Garth House DS0000013322.V273800.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, and 15. The social and recreational needs of the service users are met. Family links maintained, and nutritional needs catered for. EVIDENCE: An activities coordinator is employed in the home and compiles and implements a monthly activities programme. The choice of activities is wide and varied and meets both the individual and collective needs of the service users. During the afternoon of inspection there was a guitarist providing a music session the lounge. This sounded very popular with the service users. Three service users were preparing to go the Dorking Halls to see the Ice Show, and some service users were sitting in their bedrooms reading or listening to music. Several other Christmas activities had been arranged. Family links are encouraged and maintained. Relatives are encouraged to take an active part in the care planning process. Visitors are welcome in the home at any reasonable time. Two individual families had to opportunity to take lunch with their relatives in the garden lounge during the inspection. Four relatives were spoken to who all had very positive comments regarding the level of care being provided and the caring attitude of the staff. Garth House DS0000013322.V273800.R01.S.doc Version 5.0 Page 12 The kitchen was visited and was clean and orderly. The catering arrangements are managed by a catering company who manage the kitchen, supply the chef, and order the catering supplies. The menus were seen and these are varied, with a good choice of wholesome and nutritious food. Lunch was served in two dining rooms in a pleasant and unhurried atmosphere. Staff were observed offering support to service users who required help with feeding. Garth House DS0000013322.V273800.R01.S.doc Version 5.0 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. The complaints procedure in place is satisfactory and procedures are in place to protect service users from abuse. EVIDENCE: There is a complaints procedure in place and a copy of this is included in the service users guide. This is available to all service users and their relatives on admission to the home. A record of complaints is kept and there have been no complaints since the last inspection. The home has an abuse awareness policy in place and all staff have training in these procedures during their induction training. During conversation with staff they were able to confirm that they had undertaken this training. Garth House DS0000013322.V273800.R01.S.doc Version 5.0 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, 20, 24, and 26. Service users live in a comfortable home with access to safe individual and communal facilities. The paintwork in some hallways needs to be repainted. EVIDENCE: The location and layout of the home is suitable for the service users living there. There is ample communal space provided to include three lounge areas, an air- conditioned lounge where relatives can dine with service users and a conservatory. Two well-furnished dining rooms are also available to service users. A mature well maintained garden is accessible from all floors. The home is generally well maintained although skirting boards and paintwork in some hallways particularly between the kitchen and dining rooms is damaged from trolley and wheelchair access and needs to be redecorated. Service users bedrooms are mainly single, en-suite with three double rooms also available. The bedrooms are comfortable well decorated, and have been Garth House DS0000013322.V273800.R01.S.doc Version 5.0 Page 15 personalised to reflect service users personalities. Individual items of furniture can be accommodated. The home was free from offensive odour. The housekeeper was on duty and explained that she was responsible for three cleaners and the laundry assistant. Two of the cleaners were off duty and cleaning was ongoing throughout the inspection. The housekeeper oversees the COSHH training. Garth House DS0000013322.V273800.R01.S.doc Version 5.0 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, 29, and 30 The service users needs are met by adequate numbers of staff on duty. The recruitment procedures protect the service users. EVIDENCE: The duty rota was seen and indicated three qualified nurses, six carers, two kitchen assistants, one cook, one cleaner one housekeeper, one laundry assistant, and one maintenance man on duty who were all overseen by a Senior Sister. The number and skill mix of the staff on duty confirmed that the service users assessed needs were met. The home has a recruitment procedure in place, which safeguards the welfare of the service users. Six staff employment files were sampled and all the required documentation was in place. All staff working in the home have a Criminal Records Bureau (CRB) disclosure in place. The home is very committed to staff training and development. It provides adaptation training for nurses from overseas. It also provides placements for student nurses from Surrey University. The home has an annual audit by The University prior to the placement of students. The Sister on duty confirmed that approximately 70 of care staff have an NVQ Level 2 award in care. Qualified nurses are supported to develop their skills and training is provided externally and internally. Garth House DS0000013322.V273800.R01.S.doc Version 5.0 Page 17 Garth House DS0000013322.V273800.R01.S.doc Version 5.0 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, 37, and 38. The service users live in a well managed home and their health and welfare is promoted and protected. EVIDENCE: The registered manager is a qualified nurse with several years of experience in the provision of care to older people. She was attending an organisation management meeting and was not present during the inspection. The home was well managed by the Senior Sister Louisa Palacios who was on duty for the duration of the inspection. She had a good understanding of the assessed needs of the service users in the home and managed the staff team effectively. The standard of record keeping is good. All confidential information relating to service users and staff is stored securely when not in use. Records must now Garth House DS0000013322.V273800.R01.S.doc Version 5.0 Page 19 be maintained on the new company stationary, this should also apply to the homes policies and procedures. There is an extensive range of health and safety policies and procedures in place. Risk assessments are also in place for safe working practice. The fire records are well maintained and all staff receive regular firs safety training. The accident records were available for inspection and are also well maintained. Garth House DS0000013322.V273800.R01.S.doc Version 5.0 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 3 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X 2 3 Garth House DS0000013322.V273800.R01.S.doc Version 5.0 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 19 Regulation 23(2)(d) Requirement The registered person must ensure that all parts of the care home are kept reasonably decorated. The registered person shall ensure that records, policies and procedures are kept up to date to include new company details. Timescale for action 12/02/06 2 37 17(3)(a) 12/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 7 Good Practice Recommendations It is recommended that an individual care plan be reviewed to address noise management. Garth House DS0000013322.V273800.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Garth House DS0000013322.V273800.R01.S.doc Version 5.0 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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