Inspection on 18/04/07 for George Edward Smart Homes

This inspection was carried out on 18th April 2007.

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

George Edward Smart Homes 13/12/05

George Edward Smart Homes 19/07/05

George Edward Smart Homes 01/02/05

George Edward Smart Homes 17/08/04

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

CARE HOMES FOR OLDER PEOPLE George Edward Smart Homes Stepney Drive Scarborough North Yorkshire YO12 5DJ Lead Inspector Gill Sample Key Unannounced Inspection 18th April 2007 09:30 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.V335141.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. George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 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 375709 01723 500717 admin@george-edward-smart-homes.org.uk 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.V335141.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th December 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 Hay, 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. Information is given to new and existing service users to the home detailing the accommodation, facilities and services provided. The weekly fee is quoted by the registered manager as between £325.50 and £651.00 per week in March 2007 depending on the size of personal accommodation. The charge for over sixty per cent of rooms is £378.00 per week. Additional charges not covered by the fee are hairdressing at £6.00 for a shampoo and set, private chiropody £10.00, newspapers and magazines at cost price, and taxi fares or dial-a-ride service at cost price. People who live in the home may do their own laundry if they wish. Charges are made on a ‘cost per item’ basis where staff at the home wash the laundry. George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report gives the findings of a key inspection of the service including a site visit that was made on 18th April 2007. The inspection was made by two inspectors, was unannounced, and focussed on certain key standards which are identified in the report. The inspectors spent a total of three hours and ten minutes at the home. There were fifty one residents living at the home. Prior to the visit, the registered manager had provided written information about the service to the Commission and the background history of the home was analysed using records held at the Commissions York office. At the visit, general areas of the premises were seen and a number of bedrooms, bathrooms and living areas. Some written records were also examined and practice was observed during the visit. Individual and group discussions were held with residents, the registered manager Mrs. Elaine Heritage, and staff on duty at the time. Fourteen written comment cards were distributed to service users prior to the visit to the service twelve of which were returned to the Commission’s office in York. Written comments were also received from one general practitioner with patients living at the home. What the service does well: The service manages the care of a range of service users and their needs. This is supported by the care planning system in place which enables any temporary or permanent change to the care of individual service users to be noted and staff to be aware of these. This means that each service user can be confident that staff are vigilant about their health and wellbeing and will take action if there is concern. The service is receptive and responsive to service users’ suggestions about what and how service is provided at the home and service users have been able to influence the service in a number of ways, helped by having direct access to Trustees of the organisation. The philosophy of the home is reflected in the care which is provided. The independence of individuals living there is recognised and respected by the way in which staff relate to people and how people are treated. Those residents who need physical help are included in the organised activities provided by the home and were seen being given unobtrusive assistance at the inspection. “I like to be as independent as possible, but help is available when required”. People who live at the home had positive comments to make about their care, the food and their accommodation. “Very good, could not be better.” A George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 Page 6 relative commented, “the standard of care here is very high. My father’s needs are always looked after.” “The meals are above liking, they are excellent. Full marks to the kitchen staff”. “My father regularly takes part in (these) activities. I am certain this has contributed significantly to his high morale. The activities are regular and wide ranging.” 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. The summary of this inspection report can be made available in other formats on request. George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 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.V335141.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 does not apply. People who use the service experience good quality outcomes in this area. They can be assured that their needs will be properly assessed and recorded before entering the home and are given information so that they can make an informed choice about going to live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care records showed that a full assessment of individual need is carried out prior to anyone moving into the home. One record seen was of someone on an extended short stay with a view to living permanently at the home. This record also showed information about the person’s care needs and preferences and are maintained in a way which enables care staff to easily access the information they need to care for individuals. A range of information about the home, its services and facilities is available and was seen at the site visit in a prominent place so that people who live at the home or visitors could easily read information. Comments made by people living at the home confirmed that they had had chance to experience the home prior to moving in permanently “we came in for George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 Page 9 a holiday when the daughter went away on holiday”. A relative commented that “a full interview took place and all the appropriate information was taken”. George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience good quality outcomes in this area. Service users can be assured that their health care will be properly monitored and dealt with and that their physical, social and emotional needs will be recognised and met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care records seen showed that individual needs had been identified and detailed how these would be met. Records showed how health care needs had been recognised and monitored and where these had been referred for advice or attention from medical professionals. Discussion with a visiting community nurse confirmed that referral was made for medical attention and that staff providing care sought advice on medical matters. Care needs had been reviewed and recorded on care planning documentation where needs had changed. Service users said that staff are sensitive to their privacy and dignity when providing personal care. Care records noted how service users wish to be addressed. The monitoring of health risks such as pressure areas was recorded. Written comments from a general practitioner praised the service provided at the home. George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 Page 11 Medication needs were noted on care records and issues had been addressed. An instance of this was recorded when it was noted by care staff that a resident with failing eyesight was unable to see when they had dropped tablets. This had been resolved following discussion and agreement with the resident for care staff to deal with medication. The medication is dealt with by a monitored dosage system which is provided by a qualified pharmacist. There is no change to the system since the last inspection. A high proportion of people living at the home retain responsibility for their own medication which is reflective of the home’s philosophy of encouraging people living there to remain independent. Written comments from people living at the home about the care and support received were positive “very good, could not be better.” A relative commented “the standard of care here is very high. My father’s needs are always looked after. My father’s health needs are always dealt with promptly and effectively.” George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience excellent quality outcomes in this area. Daily life and social activities offer service users opportunities to live their preferred lifestyle and retain relationships in the wider community. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Written surveys from people living at the home were positive “the meals are above liking, they are excellent. Full marks to the kitchen staff”. “The meals provided are varied and generally accepted by most people, but I have found that if I dislike any particular meal, the staff go to considerable trouble to find an alternative which is acceptable”. “One cannot like everything, but there is usually a very good choice.” Observation of practice at the site visit confirmed that people living at the home are able to choose what they eat, and notes of a residents’ meeting confirmed that people living at the home have opportunities to influence the menus being served and make comments and suggestions to the catering staff. There are activities available to people living at the home which are wide ranging, including coffee trips outside the home as ‘mystery tours’, shopping trips into town and evening outings. One inspector accompanied a group of George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 Page 13 people from the home on a coffee trip and observed that people with disabilities were included in the outing and were given sensitive assistance to access the café by care staff. A relative commented that the activities offered at the home had “contributed significantly to his (relatives) high morale”. A number of activities are based inside the home and include physical recreation such as tea dances and tai chi, and classes in art and craft and special interest. There are facilities such as the library so that service users who do not wish to take part in organised activity have a choice about how they spend their time. Visitors were seen coming into the home and several people living at the home commented on the number of visits they received each week. George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. They are able to make a complaint using information provided by the home and are protected by the awareness of staff of potential abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints procedure in place detailing the way in which any complaint will be dealt with. The record of complaints was examined which detailed the nature of the complaint, how this was dealt with and contact with the complainant during and following the investigation. This record also details how these concerns have been dealt with. Pre inspection information confirmed that complaints received had been dealt with within a twenty eight day timescale. Letters of thanks from people living in the service and their relatives were seen. A copy of the York and North Yorkshire Adult Protection Policy is available at the home in addition to the home’s policy on how to protect vulnerable adults. The registered manager and senior staff are aware of the action to take should an abuse situation be suspected or alleged. George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience excellent quality outcomes in this area. They can be assured that the home is a clean and pleasant place in which to live and is maintained to a high standard of comfort and safety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All areas seen were maintained to a high standard of cleanliness, decoration and furnishing. The home was uniformly warm and well ventilated. The home provides a wide range of choices to people living there in terms of places to sit and spend time including quiet, smaller areas, sitting areas in corridors, large sitting rooms and a conservatory used for classes and other activities. All areas are pleasantly decorated and furnished in keeping with the building. The home is set in its own grounds containing seating areas, a summer house and paths which are maintained to a high standard. Individual bedrooms give people who live at the home space to bring their own furniture and personal belongings and those rooms seen confirmed this. George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. They can be assured that they are being looked after by well trained and competent staff whose work is properly supervised. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff rotas supplied to the Commission prior to the inspection showed that staff are on duty in sufficient numbers to address the needs of people who live at the home Employed staff have specific duties such as the provision of care, catering, domestic and maintenance support. At the visit to the home six care staff were on duty and a range of these staff including senior care staff and the activity organiser. Staff recruitment records were examined, which showed that written application, two written references and a face to face interview are required to enable the registered person to make a decision on whether to appoint a potential care worker. Criminal records disclosures were seen which were being kept as original documents. This was discussed with the registered manager and office manager, who were advised that in line with data protection legislation, a record should be kept of the detail of criminal records disclosures and PoVA checks on a securely held list. Staff training records were seen which showed individual and collective recording of training completed and enabled the registered manager and senior George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 Page 17 care staff to identify training needs. All records seen showed that newly appointed staff had received an introduction to the home and its philosophy and the systems in place which they needed to understand to enable them to carry out their duties. In addition, newly appointed staff complete induction and foundation training to Skills for Care Council specifications and are then registered to undertake NVQ level 2 in care training. Two staff spoken with at the visit to the home confirmed they had completed this training, and a third confirmed that they were due to start the training. Individual staff records had copies of certificates for training topics completed. George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use the service experience excellent quality outcomes in this area. Systems in place at the home ensure that the health, safety and welfare of residents is being addressed and people living at the home have access to the organisation so that they can contribute to the service provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Head of Home Mrs. Elaine Heritage is registered under the Care Standards Act. She has considerable experience of managing the service with the support of staff and a well defined management structure. Mrs. Heritage has obtained the Registered Manager’s Award. Trustees from the organisation are involved in checking quality standards at the home and in ensuring that residents’ views can be represented to the Trustees directly. George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 Page 19 Systems are in place at the home to ensure that the health and safety of people living at the home and staff is properly addressed. Discussion with a maintenance worker confirmed that hot water temperatures are checked throughout the home on an ongoing programme. Pre inspection information confirmed that ongoing checks of the gas and electrical systems, passenger lifts and hoisting equipment are undertaken at the home and are kept up to date. Systems are in place to ensure that people living at the home are able to raise any concern they have about the service. Residents’ meetings showed that people who live at the home have opportunities to influence the service provided at the home. Systems are in place so that service users’ money and valuables are handled in a proper way. Pre inspection information confirmed that people who live at the home manage their own financial affairs, have help from relatives or legal representatives or have an appointed Power of Attorney. Where money is held on behalf of service users, separate records are maintained. Residents have a lockable space in which to keep money or anything valuable. George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 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 X 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 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 Page 21 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 Refer to Standard OP29 Good Practice Recommendations Original criminal records bureau documents on individual staff may be destroyed and a record kept detailing this information as a securely held list, in line with data protection legislation. George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 George Edward Smart Homes DS0000007644.V335141.R01.S.doc Version 5.2 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. 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