CARE HOMES FOR OLDER PEOPLE
George Edward Smart Homes Stepney Drive Scarborough North Yorkshire YO12 5DJ Lead Inspector
Jean Dobbin Unannounced Inspection 13th December 2005 09:45 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 George Edward Smart Homes DS0000007644.V270216.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. George Edward Smart Homes DS0000007644.V270216.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service George Edward Smart Homes Address Stepney Drive Scarborough North Yorkshire YO12 5DJ 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) 01723 337509 01723 500717 admin@george-edward-smart-homes.org George Edward Smart Homes Mrs Elaine Margaret Heritage Care Home 61 Category(ies) of Old age, not falling within any other category registration, with number (61) of places George Edward Smart Homes DS0000007644.V270216.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 19th July 2005 Brief Description of the Service: George Edward Smart Homes are situated in a mature residential area of Scarborough, about one mile from the railway station and the town centre. The Home comprises two connected buildings, Combe Hey, built in 1958, and Fawcett House added ten years later. Both buildings have two floors, with service users’ bedrooms on both levels. All are en suite. George Edward Smart Homes provide personal and social care for 61 residents. Nursing care is not provided. There is a varied social calendar, and recreational activities are available for those residents interested in participating. The Home is set well back from the road in mature, formal gardens. There are parking facilities at the front of the building. George Edward Smart Homes DS0000007644.V270216.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This summary relates to an unannounced inspection on Tuesday 13th December 2005, lasting five hours including preparation work. The registered manager was present throughout the inspection. The visit included a tour of part of the Homes, and speaking with nine residents, either in their bedrooms, or in one of the communal rooms. There was the opportunity to look at some policy files related to staff training, and health and safety checks; as well as how the manger addresses any concerns from residents, relatives or staff. Four staff members were also interviewed during the visit. What the service does well: What has improved since the last inspection?
There has been more decorating work in recent months. Fawcett House dining room has been redecorated and double glass doors installed to both increase the light, and to improve the access to the activity room. The carpet in the link corridor between the two buildings has been renewed. Two bedrooms have been knocked together and redecorated to provide a flat for two people. Outside, the building work continues, to provide a storage and batterycharging facility for motorised scooters. George Edward Smart Homes DS0000007644.V270216.R01.S.doc Version 5.0 Page 6 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. George Edward Smart Homes DS0000007644.V270216.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 George Edward Smart Homes DS0000007644.V270216.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): None EVIDENCE: George Edward Smart Homes DS0000007644.V270216.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): 9 Residents can make choices about whether or not to be in charge of their own medication, and good systems are in place within the home to ensure medicines are cared for responsibly. EVIDENCE: The medication policy within the home was examined. About half the service users choose to manage their own medication, which is kept in a locked cupboard in the bedroom. These residents are assessed for this prior to moving to the home. There is ongoing assessment to ensure continued safety and compliance, with staff sometimes involving external professionals to guide them in their decision-making. Enabling residents to self medicate provides independence and control and confirms the philosophy of the home. The medication storage was looked at and there is a robust system of recording drugs delivered to the home, including those belonging to residents who self-medicate. The Controlled Drugs were stored, recorded and dispensed appropriately. The fridged items also were in order. The monitored dosing system, for those residents not responsible for their own drugs is checked weekly, and numbers of tablets are recorded. It is recommended that ‘as
George Edward Smart Homes DS0000007644.V270216.R01.S.doc Version 5.0 Page 10 required’ drugs are also counted weekly to ensure that all can be accounted for. The medication policy followed by staff at George Edward Smart ensures that residents are not put at risk by poor practice. George Edward Smart Homes DS0000007644.V270216.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): None EVIDENCE: George Edward Smart Homes DS0000007644.V270216.R01.S.doc Version 5.0 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Residents feel confident that any issues will be heard and investigated fairly, and then they will receive feedback on the investigation within a specific timescale. EVIDENCE: There is a plan on the notice board describing the home’s policy for responding to complaints. All residents and staff, who were spoken to, said that they would feel comfortable voicing their concerns and felt that their concerns would be acknowledged. There have been three situations in recent months when the manager has been asked to investigate particular incidents and these have all been dealt with, documented and resolved, within a timescale as stated within the policy. Residents feel reassured that any worries or complaints would be responded to appropriately. George Edward Smart Homes DS0000007644.V270216.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None EVIDENCE: George Edward Smart Homes DS0000007644.V270216.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29,30 Residents are protected from harm by a robust recruitment policy and an investment in training ensures that staff are equipped with the knowledge and skills to provide good quality care. EVIDENCE: The recruitment file for the newest staff member was examined during the inspection. This confirmed that written references and CRB checks had been obtained prior to her starting work at the home. These checks ensure that residents are in safe hands. The training file records mandatory study sessions such as ‘moving and handling’ and ‘fire safety’, as well as development training such as ‘Insight into eyesight study session. Regular updated training sessions means that residents are more likely to be cared for by staff with improved knowledge, skills and compassion. Those carers spoken to, felt that their role was to support and help the residents to lead full lives. They felt that they had the skills, knowledge and personal support to fulfil that role. Staff meetings and personal supervision provides the opportunity to discuss any issues with the management team. George Edward Smart Homes DS0000007644.V270216.R01.S.doc Version 5.0 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 The residents are protected by a management approach which sees health and safety as of paramount importance to ensure the smooth running of the home. EVIDENCE: The documents related to health and safety issues were looked at. These showed that emergency lighting, fire safety records, gas safety checks and hot water temperature checks were all current and in date. There had been a recent power circuits check, which was reported by both the manager and maintenance person as satisfactory. The certificate is awaited. All staff spoken to were aware of the time of the weekly fire alarm testing. Residents are reassured that health and safety policies within the home are recognised as having high priority to safeguard their health. George Edward Smart Homes DS0000007644.V270216.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 3 George Edward Smart Homes DS0000007644.V270216.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard 9 31 Good Practice Recommendations ‘As required’ medication should be counted weekly and documented to ensure all drugs can be accounted for. The manager should receive training to level4 NVQ in management and care. George Edward Smart Homes DS0000007644.V270216.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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