Inspection on 18/12/07 for Garth House

This inspection was carried out on 18th December 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 01/06/06

Garth House 15/12/05

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 Wendy Mills Unannounced Inspection 18th December 2007 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.V344710.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. Garth House DS0000013322.V344710.R01.S.doc Version 5.2 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 garthhouse@btinternet.com Assured Healthcare Limited Mrs Janet Maureen Ann Starr Care Home with nursing 42 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (42), of places Physical disability over 65 years of age (42), Sensory Impairment over 65 years of age (20), Terminally ill over 65 years of age (20) Garth House DS0000013322.V344710.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 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 42 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. It is recommended that this room be registered on a temporary basis while the married couple occupies their double room. When the double room becomes a single occupancy for whatever reason than the registration will be reduced to 41 again. 1st June 2006 Date of last inspection Brief Description of the Service: Garth House is a registered care home providing residential and nursing care for up to forty-two older people. It is now part of the Caring Homes group. The company operates numerous homes across the United Kingdom. The home offers nursing, palliative and convalescent care as well as long and short term care. There are some exceptions that allow provision of services to people between the age of sixty and sixty-five who have significant physical disabilities or whose mental capacity is failing. The home is within walking distance of Dorking Town centre. Originally an elegant three story Victorian Manor House, Garth House was converted for use as a nursing home some fifty years ago. Further extensions were added in the 1990s. Caring homes Ltd took over the management of the home two years ago. Garth House has plenty of communal space; there is a good-sized sitting room, a small quiet area, a large garden room and two dining areas. Most of the bedrooms are for single occupancy and have ensuite facilities. Outside there is well-maintained garden to the side and rear of the home. There is a car parking area at the front of the home. Garth House DS0000013322.V344710.R01.S.doc Version 5.2 Page 5 The weekly fees, at the time of this visit, ranged between £750 and £1000. Additional charges are made for items such as private physiotherapy, personal newspapers and personal telephone calls. A copy of the latest inspection report is available in the home or directly from the Commission for Social Care Inspection (CSCI). Further information about the home can be obtained directly from the registered manager, Mrs Janet Starr. Garth House DS0000013322.V344710.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This visit was unannounced. It formed part of the inspection process of the Commission for Social Care Inspection (CSCI) under the Regulations of the Care Standards Act 2000. This report has been compiled using information gained during this visit and information supplied prior to the visit from a variety of sources, including the home’s Annual Quality Assurance Assessment (AQAA) that is required by the CSCI. The observations of an expert by experience have also been used. The charity, Help the Aged provided the expert by experience, a member of the public who has personal experience in the care of older people, and the necessary training in the process of inspection. During the visit in-depth discussion was held with the registered manager, Mrs Janet Starr. Time was spent with residents, talking to them both in private and informally during a tour of the home. Visiting relatives were also spoken with and an expert by experience, a member of the public who has gained expertise in care of older people through their own experiences, assisted for a greater part of this visit. Staff were spoken to both in private and en passant and the responses to surveys sent out prior to this visit were considered. A tour of the home was made and documentation, including staff files and care plans was examined. Both direct and indirect observation was used throughout the visit. The home meets the National Minimum Standards. The residents and their relatives say that they are well cared for. They say they are able to make choices and that there is a good level of activities in the home. The home has met all the requirements placed at the last inspection. The residents, their relatives, staff at the home and registered manager are thanked for the welcome they gave and their help throughout this visit. The charity, Help the Aged, and the expert by experience are thanked for their assistance with this inspection. What the service does well: Garth House DS0000013322.V344710.R01.S.doc Version 5.2 Page 7 The home is well managed. It has a good organisational structure. This means all staff are clear about their roles and responsibilities. The residents are treated with a great deal of respect. Their privacy and dignity are preserved and the home actively promotes their health and wellbeing. The care at the home is good. Residents said that the staff are kind and caring. One resident described the home as, “Top of the range”. The home provides spacious and well-maintained accommodation, set in landscaped and safe grounds where residents are free to enjoy their surroundings. What has improved since the last inspection? What they could do better: The home must work harder to control the strong offensive odours that are occurring in two specific areas of the home. More attention to detail is needed when the registered person and responsible individual tour the home. In particular, equipment that needs replacing, for Garth House DS0000013322.V344710.R01.S.doc Version 5.2 Page 8 example, toilet aids that have significant rust, is dealt with in an appropriate and timely way. The home could consider providing individualised summaries of care plans to be held discretely in the residents’ rooms. These summaries might contain information about their likes and dislikes, preferred times for meals and other wishes. This may ensure that personalised care is given at all times. This is especially important should residents be receiving care from new or agency staff. 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. Garth House DS0000013322.V344710.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 Garth House DS0000013322.V344710.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): 1&3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides the residents, their relatives and supporters, with the information they need in order to make a decision about moving into the home. Appropriate pre-admission assessments are made. This ensures that only those residents who are suited to the home and whose needs can be met are admitted to the home. Garth House DS0000013322.V344710.R01.S.doc Version 5.2 Page 11 EVIDENCE: The home has produced a new statement of purpose and service user guide since the last inspection. A clear and concise complaints policy and procedure is included in the service user guide. Inspection of a twenty percent sample of care plans showed that appropriate pre-admission assessments are made. The registered manager said that she and/or her deputy carry out most of these. Both are qualified nurses who have many years experience in health and care services. Residents and their relatives confirmed that a representative from the home had visited them prior to admission. Arrangement can be made for trail periods in the home before a final decision is made to move into the home. Garth House DS0000013322.V344710.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): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home promotes the health of the residents and respects their privacy and dignity. This means that the residents can enjoy their lives in the home feeling as well as possible. EVIDENCE: Residents and their relatives all said that they receive very good care from the staff. Direct and indirect observation showed that staff are very professional in their approach. On the day of this visit they were seen to be efficient, kind and discrete. One resident said, “The staff are kind, very kind and good”. Responses received from comment cards stated that the home “always” meets their needs. Garth House DS0000013322.V344710.R01.S.doc Version 5.2 Page 13 Care planning has improved since the last inspection. Since taking over, Caring Homes Ltd have introduced a corporate format for care plans. Staff have now transferred all information into this new format. The care plans examined clearly indicate that appropriate reviews take place and that the needs of the residents, in all aspects of their lives, have been noted. Where residents and/or relatives have been in agreement, life histories have been written. Diverse interests and aspirations are noted. Cultural and religious needs are also recorded in the care plans. There was clear evidence that residents have been involved in their care planning. The residents spoken to were aware of their care plans and had been involved to the extent they wished to be in the review of these plans. Relatives said they were consulted and informed of care decisions if appropriate and that they are consulted about important matters affecting their relatives in the home where it is not possible for the residents to deal with such matters themselves. Daily check lists for care routines are kept in each resident’s room and these are up-to date. Residents and their relatives said that the staff always respect their privacy and dignity. Direct and indirect observation on the day of this visit confirmed this. This was particularly evident at mealtimes when staff were very discrete and diplomatic about the way they offered help. The home has a pressure sore prevention programme. There is a range of pressure relieving equipment and new air mattresses have been purchased since the last inspection. The incidence of pressure sores in the home is low. The registered manager said that the home works closely with specialist services, such as the local continence advisory service, to ensure they use best practice in care. However, in two areas of the home, there were very strong offensive odours. The manager said that they had taken advice and were doing everything possible to manage the situation. She said there are some environmental changes planned to try to address the problem and that staff are working hard to ensure continence is promoted and managed. Exercise is encouraged. There are regular exercise classes. One was in progress on the day of this visit. Indirect observation of this class showed that not only did it encourage all who were taking part, to extend their physical ability but that they were having a lot of fun as well. Garth House DS0000013322.V344710.R01.S.doc Version 5.2 Page 14 When the weather permits, several of the residents enjoy taking exercise in the well-maintained gardens. Residents said that they enjoy the gardens a lot and get out there when they can. The gardens have safe pathways and some raised flowerbeds where residents can create their own gardens if they wish. All residents are registered with a general practitioner (GP). A GP visits the home weekly and at other times if necessary. Good records are kept of these visits. Inspection of the daily log, tracking to care plans and relatives and residents comments, showed that appropriate referrals to specialist health care services such as hospital consultants, physiotherapists, occupational therapists and speech and language therapists, are made and kept. Transport and escorts are arranged for these visits if relatives are unable to accompany residents. Some additional changes may be made for transport and escorts. Staff were observed to use universal infection control procedures. Protective clothing and gloves are accessible to staff and suitable disposal arrangements are in place for the management of clinical waste. The home has are sound policies and procedures for the management and administration of medicines. Medicines are stored securely and a larger medicines trolley has been purchased since the last inspection. There is separate lockable storage for medicines for internal use and those requiring cool storage. Oxygen levels and medication refrigerator temperatures are all regularly monitored and records maintained Indirect observation of staff administering medicines on the day of this visit showed that their practice is in line with recommended procedures. Residents can choose to self-medicate if they are able. They can also have their medication at different times, if that suits them; for example, if they wish to rise a little later or are going out. Garth House DS0000013322.V344710.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): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home supports the residents to make informed choices and to take part in appropriate activities. This means that they can continue to lead enjoyable and interesting lives whilst maintaining as much independence and autonomy as possible. EVIDENCE: The home supports the residents to maintain as much independence as possible. Risk taking is appropriately balanced with need to care and protect. Appropriate risk assessments are in place in the care plans that were examined. Residents, who were able, said that they can choose what they wish to do and that there are good choices about how they spend their time. Some said that they know there are various activities but usually prefer to spend time in their rooms, reading, watching the television or listening to the wireless. Likes and dislikes, interests and cultural and religious needs are noted in the care plans with each resident’s permission. This information is stored securely in the staff office. However, it may help staff to have easier access to such Garth House DS0000013322.V344710.R01.S.doc Version 5.2 Page 16 information. For example, a brief précis of likes and dislikes, preferred activities and times for these, kept discretely in each resident’s room, would mean that staff could check that appropriate activities are encouraged and that individual wishes are always respected. Visitors said that they are made very welcome to the home. They can have meals at the home if they wish. One relative said, “They support me as well.” They know that are welcome at any reasonable time. Residents can choose to have telephones in their rooms but have to pay for their calls. There is a payphone in a quiet area on the ground floor. Two part-time activity co-ordinators work in the home for a total of thirtyseven hours. They work well together and have produced an interesting activities programme. They support resident to write their life histories. These are included in the care plans for those residents who wish. On the day of this visit the home had been very tastefully decorated for Christmas. The staff are commended for the way they had made the home look so seasonal. There was exercise session in the morning and in the afternoon, a group of singers from a local school came to sing carols. Other special occasions such as Easter, Halloween and birthdays are celebrated with parties and other events such as games and quizzes. The home now produces a newsletter that lets everyone know about forthcoming events, tells of life within the home and contains items about staff and poems and recipes contributed by residents. The home has very well maintained gardens and there is a garden room that leads on to a patio with a barbeque area and raised flowerbeds so residents can participate in outdoor activities in the summer. Residents said that they enjoy the garden very much. Garth House has an equal opportunity admissions policy that values diversity. At the time of this visit there were no residents from ethnic minorities. Local churches provide communion services and church services. The home has information about other religions and many of the staff are nurses from overseas. There is a wide ethnic mix of the staff. One resident said, “This is good. It makes life much more interesting. I like hearing about their lives in other countries. There is no problem with understanding them, they all speak good English”. Since the last inspection a new chef and kitchen assistant have been appointed. They hold appropriate food hygiene certificates. Inspection of Garth House DS0000013322.V344710.R01.S.doc Version 5.2 Page 17 food storage and conversation with the chef confirmed that there is plenty of good quality, fresh produce. The expert by experience, a member of the public who is allied to Help the Aged, and has significant experience in the care of older people, ate lunch with some of the residents. This gave her a chance to sample the food, to talk to some of the residents and to indirectly observe the way staff help those who need it. Her opinion was that the meal was well cooked and tastefully served. Observation of staff showed that they gave assistance in a discreet, patient and caring way at all times. Residents said that they enjoy their meals. There is a varied menu and special diets are catered for. Residents can choose where they take their meals. Some like to sit together in the main dining area whilst some like to eat in their rooms. The manager stated that the kitchen had been deep cleaned since the last inspection and a new food mixer has been purchased in accordance with the requirements made at the last inspection. Garth House DS0000013322.V344710.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): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sound policies and procedures for the handing of complaints, concerns and protection. This means that the home listens and acts upon the views of residents, their supporters and staff and does all in its power to protect the residents from harm. EVIDENCE: The complaints policy and procedure has been revised. It is contained in the home’s Statement of Purpose and Service User Guide. A copy is also displayed in the entrance hall along with complaint/suggestion forms. There have been two complaints since the last inspection. Both complaints were investigated by the home in accordance with the home’s complaints policy. Where indicated, staff were advised and procedures tightened. There are written records of the investigations complaints and their outcomes. These were supplied to the CSCI and found have been dealt with in a satisfactory way. Garth House DS0000013322.V344710.R01.S.doc Version 5.2 Page 19 There are sound policies and procedures in place for the protection of Vulnerable Adults (POVA). Staff confirmed that they have had training and records show this to be so. POVA is also included as part of the induction process. Conversation with staff showed that they are aware of the need to report any concerns that they might have immediately. They said that they would have no hesitation in doing so and were clear about to whom they should report any concerns. They said that there are always enough staff on duty and they felt sure that they would notice if any member of staff was not doing their duty. Garth House DS0000013322.V344710.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): 19, 22 & 26 Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. The environment is safe, clean and well-maintained. This gives the residents a pleasant place in which to live. However, more attention to detail is required to ensure that standards of tidiness and health and safety do not slip. EVIDENCE: The premises had been extended and restored over the years, combining modern facilities with the original architectural features of the building. This has created an elegant, comfortable nursing home environment, which is well decorated and well maintained. However, some carpets are now looking rather tired and in two areas there are very strong offensive odours. Garth House DS0000013322.V344710.R01.S.doc Version 5.2 Page 21 The home has extensive, mature landscaped gardens and many of the rooms have views over the gardens. There is an air-conditioned garden room, with direct access to a large furnished patio area and the garden. There are also plenty of sitting areas in the home with pleasant views over the gardens. Some bedrooms were viewed, with the permission of the residents. The bedrooms viewed have all been personalised. They were clean and comfortable. The residents said that they like their rooms. One said, “It’s top of the range - you can’t beat that view”. All but two bedrooms have ensuite facilities. All rooms have a nurse call system. There are four assisted bathrooms with a choice of bath or shower. The communal areas are comfortable, well ventilated and tidy. On the day of this visit the home was very tastefully decorated for Christmas. The staff are commended for the effort they have made to ensure all communal areas are so tastefully decorated and festive looking. A tour of the home was made in company of the registered manager and the expert by experience. Hot water temperatures were safe, radiators and guarded and the windows are fitted with restrictors. The maintenance book was inspected and found to be in good order. The maintenance person explained how he carried out the regular health and safety checks and communicated with the manager if there are any maintenance requirements. The home has assisted bathrooms and appropriate equipment, such as hoists, for safe moving and handling. A new hoist has been purchased since the last inspection. En suite facilities have appropriate toilet aids, however, the paint on some of these is chipped. This has led to some rusting. Even though the toilet aids were clean, the areas of rust present and infection control risk. This equipment should be replaced as a matter of urgency. Whilst no serious health and safety risks were noted during a tour of the home, there was one area on the first floor corridor where some old furniture and boxes had been left. The manager said that these were waiting to be removed. This area should be cleared as soon as possible. Garth House DS0000013322.V344710.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): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels, staff training and skill mix and staff morale are all good. This means that a cheerful and well-qualified staff team care for the residents. There are rigorous recruitment policies and procedures in place. This means that a carefully vetted staff team work at the home. EVIDENCE: A recorded staff rota is in place. This shows that a good mix of qualified nurses and care staff are on duty for each shift. Staff said that there are always enough staff on duty to meet the residents’ needs. Examination of a twenty percent sample of staff files showed that there is a good range of skills amongst the staff. Several of the nurses are from overseas and are undertaking the adaptation required to become Registered General Nurses (RGNs) in Britain. Many of these nurses do not have English as their first language but no problems were noted with communication throughout the visit. Some residents said that they thought it added variety to their lives. They said that they like hearing about other cultures. Garth House DS0000013322.V344710.R01.S.doc Version 5.2 Page 23 The staff were observed to be very professional in their demeanour and conduct. They were kind and courteous to the residents. The expert by experience observed that all the staff related well to the residents and met their needs in a kind, courteous, gentle and unobtrusive manner. There are sound employment policies and procedures. Examination of staff files showed that all appropriate pre-employment checks are made. There are a significant number of overseas nurses working at the home. They have all been properly checked. The registered manager has received training from the British Immigration Department in methods for vetting overseas staff. Overseas staff whose first language is not English are supported to attend local English classes. Residents said that they had no problem understanding them. One resident said it was a very positive thing having nurses from overseas as it made life much more interesting. The company has it’s own training company and most of the statutory training for staff is provided through this subsidiary company. There is a comprehensive training programme from induction training through to adaptation and specialist training for qualified nurses. Over fifty percent of staff hold the National Vocational Qualification (NVQ) at level two or above. Examination of staff files confirmed that staff are attending appropriate training. The home achieved the Investors in People (IIP) Award over ten years ago and has maintained accreditation ever since. IIP focuses strongly on staff training and cannot maintain accreditation if staff training does not meet IIP standards. The registered manager has extensive experience in managing nurse education programmes. She maintains strong links with the Universities of Surrey and Sheffield to ensure nurse education is up-to-date. The home provides clinical placements for student nurses from the University of Surrey. This means that there is good two-way communication in respect of continuing education between the home and education providers. Garth House DS0000013322.V344710.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): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run and the views of the residents, their supporters and staff are listened to and acted upon. This means that the home is run in the best interests of the residents. EVIDENCE: The registered manager is a qualified nurse who has extensive relevant experience in public and private health care sectors. She was head of nurse education at the Hammersmith Hospital before taking up the post as manager at Garth House. She holds diplomas in education and higher education and the Registered Managers Award (RMA). She is also a student nurse assessor. Garth House DS0000013322.V344710.R01.S.doc Version 5.2 Page 25 The registered manager has budget control for the day-to-day running of the home. This includes food purchase, staff training and day-to-day maintenance and minor replacements. She line manages all senior nursing staff. Since the last inspection a deputy has been appointed and this means that some of the supervisory role of staff is shared. Some staff are clear about their job roles and lines of responsibility. They said that they could talk easily to the manager and felt she was fair in the way she runs the home. On the day of this visit the registered manager was on duty and assisted throughout the inspection. She was observed to interact well with the residents, relatives and staff. Residents were very positive in their comments, referring to her as, “Matron”. They said, “We can always ask Matron, if we have any worries”. Relatives were equally positive about the manager. They said that she communicates well with them but does not worry them unnecessarily. Caring Homes Ltd has clear policies and procedures for quality assurance. They carry out regional quality audits that take into account the views of the residents, their supporters and staff. A representative of the company makes monthly visits to the home and reports in accordance with Regulations. Records are stored appropriately and the home complies with the Data Protection Act. Employers and public liability insurance is in place. The insurance and registration certificates are displayed in the entrance hall. There are comprehensive Health and Safety policies and procedures in place. Environmental risk assessments have been undertaken. The safety hazard of the unlocked door to stairs to basement laundry noted at the last inspection has been addressed. This door is now fitted with a lock. The accident book is kept up-to-date and was examined and found to be in order. Garth House DS0000013322.V344710.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 3 X 3 X X N/A 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 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 2 X X X 2 STAFFING Standard No Score 27 4 28 3 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 3 Garth House DS0000013322.V344710.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 OP22 Regulation 13(3) Requirement The registered person is to ensure all measures are taken to ensure infection control. In particular toilet aids used in en suite facilities that are rusting to be replaced. The registered person to ensure all areas of the home are kept free from offensive odours. In particular attention must be given to two specific areas in the home identified during this visit. Timescale for action 28/02/08 2 OP26 16(2)(k) 28/02/08 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 Refer to Standard OP12 Good Practice Recommendations The home should consider producing summaries of the way each resident likes to spend their time that could be made available in their rooms. Garth House DS0000013322.V344710.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Garth House DS0000013322.V344710.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. 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