Inspection on 18/07/05 for Garth House

This inspection was carried out on 18th July 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 15/12/05

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 Announced 18 July 2005 10:00 th 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 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 h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Garth House Address Tower Hill Road, Dorking, Surrey, RH4 2AY Telephone number Fax number Email 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 Jane Starr CRH N 41 Category(ies) of OP - Old Age: 41 registration, with number DE(E) - Dementia - Over 65: 20 of places PD(E) - Physical Disability - Over 65: 41 TI(E) - Terminally Ill - Over 65: 20 SI(E) - Sensory Impairment - Over 65: 20 Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 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 29/11/04 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. Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and the first in The Commission for Social Care Inspection programme 2005/2006. Mary Williamson who is the Lead Inspector for the home undertook the inspection over five and a half hours. The registered manager Jane Starr was present throughout the inspection. Six Service Users comment cards, fourteen Relatives comments cards, three Health and Social Care comment cards and one comment card from a GP were received by the inspector prior to the inspection. Over 70 of the service users, five relatives, several staff, and an activities instructor were spoken to throughout the inspection. There was positive feedback from the service users spoken to regarding the care provided in the home. Relatives also felt supported by the manager and her staff team. 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. The catering arrangements are satisfactory and the food offered is appetising and wholesome. There was an exercise class taking place in the lounge during the morning, which was well attended and a church service taking place during the afternoon. The inspector would like to thank the service users, relatives, staff, and management team for their helpful and positive contribution 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 caring and positive way to service users. Privacy and dignity are respected and staff ware observed to knock on service users doors prior to entering. Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 6 The home is well maintained and the standard of decoration and cleanliness is of a high standard. The home is well managed and the manager is very committed to the training and development of her staff team. 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 h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 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 standard(s) 1, 2, 3, and 5 Evidence gathered during the inspection confirmed that service users and their relatives have the necessary information available to make an informed choice about the home. Evidence also suggests that the assessment process in place determines the suitability of the placement. EVIDENCE: The home has a statement of purpose and service user guide in place, which is updated every year. A copy of this is available to all prospective service users and their relatives on admission to the home. The home manager stated that she undertakes a full needs assessment on all service users prior to admission. The home has its own assessment format for this, which was sampled during the inspection. Written contracts of occupancy are in place in individual files and were seen during the inspection. Trial visits are encouraged for coffee or a meal. Two relatives stated that they visited on behalf of their parents due to lack of capacity. Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 9 Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 10 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 standard(s) 7, 8, 9, and 10 Evidence gathered during the inspection confirmed that personal and social care needs identified in individual care plans are being met with dignity, and that service users receive their medication safely. EVIDENCE: Individual care plans are in place. These are written with information gathered at the preadmission needs assessment, input from the service user and their relatives, and any other medical reports available on completion. These care plans are kept in service users rooms. The care plans sampled during the inspection were very person centred and well maintained. These are reviewed on a regular basis or when needs change. Risk assessments covering mobility, nutrition, and pressure area care are also included in these plans. All service users are registered with a local GP who visits the home weekly or more frequently if required. Visits are also arranged from the chiropodist, dentist, and optician. There is access to a tissue viability nurse, and the home has a wide range of pressure relieving equipment in place for the service users being nursed in bed. Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 11 The home has a policy in place for the administration of medication. The medication recording charts were seen and are well maintained. Boots the chemist supply the medication in blister pack form. They also carry out regular audits and training. One service user self medicates and a risk assessment is in place for this. Controlled medication is stored and documented correctly. Accommodation is provided in mainly single rooms, with the three double rooms all having screens supplied. Staff were observed to knock on bedroom and bathroom doors prior to entering. A policy relating to privacy and dignity was seen and a member of staff stated that this was explained to her when she started to work in the home. Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 12 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 standard(s) 12, 13, and 15 Evidence gathered during the inspection confirmed that individual lifestyles are catered for. Service users dietary needs are also being met. EVIDENCE: An activities coordinator is employed in the home and compiles and implements a monthly activities programme. This is wide and varied and meets service individual and collective needs. On the morning of the inspection an exercise class was taking place in the large lounge and was well attended. The inspector had the opportunity to talk with the instructor facilitating the class who stated that the class is very popular and she receives positive feedback from the service users who attend. Some service users chose to spend time alone reading their daily newspaper or listening to music. Other activities include art and craft classes, card games, old films, and outings. Community links are maintained and relatives are encouraged into the home at any reasonable time. There was the opportunity to talk with five relatives throughout the day and fourteen relatives comment cards were received prior to the inspection. Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 13 Spiritual needs are supported and several local clergy visit the home on a regular basis. The catering arrangements are flexible and meet the dietary needs of the service users. The menus are seasonal and planned by the chef and the manager with input from the service users. Drinks and snacks are served throughout the day by a dedicated team of kitchen staff. Lunch served on the day of the inspection was a mixed grill with a selection of vegetables and potatoes, followed by a choice of deserts. Service users were using both dining rooms, which provide a relaxed and unhurried atmosphere. The kitchen is well managed and was clean and orderly. All monitoring records are up to date for example fridge and freezer temperatures. The last EHO visit was 24/03/2005 and was satisfactory. Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 14 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 standard(s) 16, and 18 Evidence gathered during the inspection confirmed that service users are listened to and there are procedures in place to protect them from abuse. EVIDENCE: There is a complaints procedure in place and this is included in the service users guide. A copy of this is given to all service users and their relatives on admission to the home. A record of complaints is kept and there has been one complaint since the last inspection. This was solved by a meeting with the family involved and the senior care team. The home has an abuse awareness policy in place and all staff have training in this during their induction programme. This information and dates have been supplied in the pre inspection questionnaire. One staff member confirmed that they would have no hesitation in reporting an incident of abuse to the manager. Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 15 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 standard(s) 19, 20, 24 and 26 Evidence gathered during the inspection confirms that service users in a safe well maintained and clean environment, which meets individual and communal needs. EVIDENCE: A tour of the premises was undertaken. Service users live in a safe well maintained environment. There is ample communal space available to include three lounge areas, an air- conditioned garden lounge where relatives can dine with service users and a conservatory. A mature large garden is accessible from all floors. Service users bedrooms are mainly en-suite with three double rooms also available. Bedrooms have been personalised to reflect service users personalities. Service users can arrange to bring individual items of furniture into the home. All service spoken to were very satisfied with the standard of accommodation offered. Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 16 The home is clean and tidy and free from offensive odour. The housekeeper stated that she is responsible for three full time cleaners and the laundry assistant. She oversees the basic training and COSHH procedures. She also stated that she works one day a month in a one to one supervision capacity. Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, and 30 Evidence gathered during the inspection confirmed that a competent and trained staff team is meeting service users needs safely. There was one minor shortfall in the recruitment documents. EVIDENCE: Staff duty rotas were sent to the inspector prior to the inspection, and the staff duty rotas examined on the day of the inspection, together with direct observation confirmed that there were sufficient staff on duty to meet the assessed needs or the service users. There is a recruitment procedure in place and all staff working in the home have a current Criminal Records Bureau (CRB) disclosure in place. Two staff employment files were examined, and although well maintained there was only one written reference in place for one staff member. The manager is very committed to staff training and development. The home provides adaptation training for nurses overseas. It also provides placements for student nurses from Surrey University. The home has an annual audit by the University prior to the placement. Training files were seen and over 70 of care staff have undertaken NVQ level 2 training. Qualified nurses are supported to develop their careers and training courses are provided externally and internally. Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 18 Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, and 38 Evidence gathered during the inspection confirmed that the service users live in a well managed home and their health and welfare promoted and protected safely. EVIDENCE: The registered manager is a qualified nurse with considerable experience in the provision of care for elderly people. She is also a former nurse tutor and very committed to the development and training of her staff team. Several comment cards from health and social care professionals confirmed her professionalism and management skills. There is an extensive range of policies and procedures in place relating to health and safety. Risk assessments are in place for safe working practice. Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 20 The fire records were seen and are well maintained. Staff receive regular training in fire safety. Contracts are in place for the servicing of fire fighting equipment. Accident records are well maintained. All staff are trained in and are aware of COSHH procedures. Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 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 3 3 x x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x x x 3 Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 22 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 29 Regulation 19(1)(b) Requirement The registered person must ensure that two written references are in place prior to commencement of employment. Timescale for action 30/09/05 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 Good Practice Recommendations Garth House h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 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 h09-h58 s13322 Garth House v227102 180705 stage 4.doc Version 1.40 Page 24 - 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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